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Förförande idéer - kvalitetssäkring i hälso- och sjukvården

Erlingsdottir, Gudbjörg LU (1999)
Abstract (Swedish)
Popular Abstract in Swedish

Många idéer cirkulerar kontinuerligt inom och mellan olika fält i samhället. En del av dessa idéer blir på modet och betraktas som legitima lösningar på olika slags problem. Bland dessa kan organisationer – såväl offentliga som privata - lätt hitta färdiga paketlösningar till hur de exempelvis skall styra, leda eller budgetera sin verksamhet. Kvalitetssäkring blev en sådan idé på modet inom hälso- och sjukvården i början på 1990-talet.



I den här studien följs två kvalitetssäkringsidéers resor inom hälso- och sjukvården. Några av de frågor som besvaras är varför och var idéerna dök upp. Vilka problem sågs de som lösningar till? Var idéerna beroende av andra idéer och trender?... (More)
Popular Abstract in Swedish

Många idéer cirkulerar kontinuerligt inom och mellan olika fält i samhället. En del av dessa idéer blir på modet och betraktas som legitima lösningar på olika slags problem. Bland dessa kan organisationer – såväl offentliga som privata - lätt hitta färdiga paketlösningar till hur de exempelvis skall styra, leda eller budgetera sin verksamhet. Kvalitetssäkring blev en sådan idé på modet inom hälso- och sjukvården i början på 1990-talet.



I den här studien följs två kvalitetssäkringsidéers resor inom hälso- och sjukvården. Några av de frågor som besvaras är varför och var idéerna dök upp. Vilka problem sågs de som lösningar till? Var idéerna beroende av andra idéer och trender? Tolkades idéerna på samma sätt av idébärarna i statliga myndigheter som ute i hälso- och sjukvårdspraktiken? Och vad hände när idéerna mötte de befintliga rutinerna på vårdgolvet? I studien följs hur idén om kvalitetssäkringar institutionaliserades – från det att den började göra sig gällande i hälso- och sjukvården, tills den blev lagstadgad i slutet på 1990-talet. En diskussion förs kring de problem som uppstår när organisationer inom offentlig förvaltning låter sig ”förföras” av idéer från privat näringsliv. Det finns en risk att vällovliga ambitioner leder till negativa konsekvenser, eftersom idéerna används där de inte hör hemma. (Less)
Abstract
The aim of this study was to expand our understanding of the processes of institutionalisation both within and between organisational fields. This was done by tracing an idea – the idea of quality assurance – through the process of institutionalisation in the health care sector. The new institutional theory, which focuses on the relation between organisations and the institutions they are considered to be a part of, forms the basis of the study. Tracing two quality assurance-models back to their origins I found that the models originated from and represented two different ideas. I thus ended up having two different processes of institutionalisation to compare. The two ideas are called the idea of quality assurance and the idea of... (More)
The aim of this study was to expand our understanding of the processes of institutionalisation both within and between organisational fields. This was done by tracing an idea – the idea of quality assurance – through the process of institutionalisation in the health care sector. The new institutional theory, which focuses on the relation between organisations and the institutions they are considered to be a part of, forms the basis of the study. Tracing two quality assurance-models back to their origins I found that the models originated from and represented two different ideas. I thus ended up having two different processes of institutionalisation to compare. The two ideas are called the idea of quality assurance and the idea of accreditation. The analysis shows, on the one hand, that the institutionalisation of the quality assurance idea has been a ”free” process in which different authorities and organisations have been able at different times to interpret the idea in different ways. On the other hand, it reveals the institutionalisation of the accreditation idea as a ”controlled” process in which the idea is literally copied by everyone who touches it. The institutionalisation of the accreditation idea thus shows that there are ideas that can not be decoupled or buffered from the actions on the shop floor. This is what I call isopraxism. The idea of quality assurance is an example of how ideas are adopted from the private sector to the public sector which is typical for the New Public Management trend. The trend has thus been described as an identity crisis in the public sector which leads organisations in the public sector to seek for images amongst those organisations that are considered successful by standards of the private sector. The idea of accreditation is, in its turn, an example of institutionalisation between different countries but in similar fields as a consequence of the EU. Such institutionalisation is meant to lead to homogenisation. Finally, it is concluded that using ideas in fields or spheres where they do not belong can constitute quite a risk – good intentions may turn into bad consequences when applied where they do not belong. (Less)
Please use this url to cite or link to this publication:
author
opponent
  • Professor Røvik, Kjell-Arne, Tromsø Norway
organization
alternative title
Seductive Ideas: - Quality Assurance in Health Care
publishing date
type
Thesis
publication status
published
subject
keywords
Organizational science, health care, Quality Assurance, institutionalism, institutionalisation, New Public Management, isomorphism, auditing, isopraxism, Organisationsteori
pages
237 pages
publisher
Gudbjörg Erlingsdóttir, Department of Business Administration, Lund University, Box 7080, 220 07 Lund, Sweden,
defense location
Crafoordsalen EC I
defense date
1999-10-29 10:15
external identifiers
  • other:ISRN: LUSADG/SAEK-99/1056
ISBN
91-628-3777-X
language
Swedish
LU publication?
yes
id
c326cc7d-c26b-419e-9bb8-e0a9dc8f97c5 (old id 19283)
date added to LUP
2007-05-25 09:13:50
date last changed
2016-09-19 08:45:06
@phdthesis{c326cc7d-c26b-419e-9bb8-e0a9dc8f97c5,
  abstract     = {The aim of this study was to expand our understanding of the processes of institutionalisation both within and between organisational fields. This was done by tracing an idea – the idea of quality assurance – through the process of institutionalisation in the health care sector. The new institutional theory, which focuses on the relation between organisations and the institutions they are considered to be a part of, forms the basis of the study. Tracing two quality assurance-models back to their origins I found that the models originated from and represented two different ideas. I thus ended up having two different processes of institutionalisation to compare. The two ideas are called the idea of quality assurance and the idea of accreditation. The analysis shows, on the one hand, that the institutionalisation of the quality assurance idea has been a ”free” process in which different authorities and organisations have been able at different times to interpret the idea in different ways. On the other hand, it reveals the institutionalisation of the accreditation idea as a ”controlled” process in which the idea is literally copied by everyone who touches it. The institutionalisation of the accreditation idea thus shows that there are ideas that can not be decoupled or buffered from the actions on the shop floor. This is what I call isopraxism. The idea of quality assurance is an example of how ideas are adopted from the private sector to the public sector which is typical for the New Public Management trend. The trend has thus been described as an identity crisis in the public sector which leads organisations in the public sector to seek for images amongst those organisations that are considered successful by standards of the private sector. The idea of accreditation is, in its turn, an example of institutionalisation between different countries but in similar fields as a consequence of the EU. Such institutionalisation is meant to lead to homogenisation. Finally, it is concluded that using ideas in fields or spheres where they do not belong can constitute quite a risk – good intentions may turn into bad consequences when applied where they do not belong.},
  author       = {Erlingsdottir, Gudbjörg},
  isbn         = {91-628-3777-X},
  keyword      = {Organizational science,health care,Quality Assurance,institutionalism,institutionalisation,New Public Management,isomorphism,auditing,isopraxism,Organisationsteori},
  language     = {swe},
  pages        = {237},
  publisher    = {Gudbjörg Erlingsdóttir, Department of Business Administration, Lund University, Box 7080, 220 07 Lund, Sweden,},
  school       = {Lund University},
  title        = {Förförande idéer - kvalitetssäkring i hälso- och sjukvården},
  year         = {1999},
}