<p>En kvalitativ intervjustudie har genomförts på fem vårdcentraler i Stockholms län där syftet var att undersöka om nio distriktssköterskor upplever att deras psykosociala arbetsmiljö har förändrats sedan införandet av Vårdval Stockholm. Jag ville också undersöka hur de i sådana fall upplevde att det har förändrats, om det fanns skillnader i denna upplevelse beroende på i vilket socioekonomiskt område de arbetar inom samt hur förändringarna skiljer sig från effekter av tidigare vårdreformer. Eftersom Vårdvalsreformen infördes i årsskiftet 2007/2008 finns det knappt någon forskning om denna reform och därför skulle den här studien kunna bidra med intressanta resultat. Teorier och tidigare forskning behandlar psykosocial arbetsmiljö, arbetsmiljöns utveckling under 1990-talet inom välfärdstjänsteområdet samt effekter av ett New Public Management-inspirerat styrsystem på sjukvårdens arbetsmiljö. Resultaten av den här studien visar att på alla vårdenheter upplever respondenterna en förändring i den psykosociala arbetsmiljön efter införandet av Vårdval Stockholm som ofta uttrycks som en utveckling åt det sämre, men förändringen är olika stor på de olika vårdenheterna. De största förändringarna har skett i området Sydvästra 1 och i Innerstadsområdet, medan Norrortsområdet tycks ha påverkats minst. Förändringarna tar sig uttryck i minskade resurser, främst i form av personal som leder till stress och ohälsa. Detta gäller dock inte alla enheter. Tidsbristen leder till ett minskat socialt stöd vilket bidrar till minskad arbetsglädje. Nya krav anses främst felaktiga och svåra att hantera, dessutom undergräver de det egentliga distriktssköterskearbetet. I det empiriska materialet finns det inga skillnader i deras upplevelser som enligt denna studiens omfattning kan förklaras av den socioekonomiska situationen i de olika områdena. Det är inte mycket i resultaten som verkar skilja sig från situationen under 1990-talet och alltså därmed från effekter av tidigare vårdreformer. Därför är det svårt att avgöra om de upplevda förändringarna beror på Vårdvalet, om de förstärkts av Vårdvalet eller om de inte alls påverkas av reformen.</p>

<p><strong>Problem.</strong> With the Swedish public sectors problem with efficiency in mind, several reforms have beeninitiated during the last decades. These reforms go, in academic contexts, under the name“New public management”. The reforms have resulted in, among other things, an increasedcompetition, privatization and goal-orientation in the public sector. These new conditionshave changed the public leadership challenge and demand an increased focus on innovation todecrease costs and increase value as a central aspect of the Swedish public leadership.</p><p><strong>Purpose.</strong> The purpose for this research has been to examine the conditions for innovation in a publicorganization and how the leadership can improve the organizational innovativeness.</p><p><strong>Method</strong>. This research does not aim to measure the innovativeness in a public organization, instead itfocuses on understanding the condition for innovation and how the leadership can affect theorganizational innovativeness. Hence, it is motivated that I use a qualitative approach in theresearch process. Semi structured interviews and precedent research are being used as afoundation for the results and recommendations given.</p><p><strong>Conclusion.</strong> The leadership’s opportunities to improve the organizational innovativeness depend on anumber of independent organizational variables and the adaption of the variables to oneanother and the system as a whole. Leadership includes both the formal boss and the coworkerin a relationship that ought to be characterizing by reciprocity and cooperation. Bothmanagement and leadership are vital competences for the formal boss as both structure andculture must support each other. The conditions for organizational innovativeness improve ifthe organization has a structure and a culture that enhances: transboundary cooperation, spaceand energy for creative activities, a common context that contributes to an organizationalidentity and motivation and competence and organizational learning. The examinedorganization needs to decentralize the right to make decisions, improve the openness of theculture, and strengthen the organizational identity and audit structures in purpose to facilitatetransboundary cooperation.</p>

La performance s'impose aujourd'hui dans le secteur public. Néanmoins le contenu que recouvre la notion reste sujet à débat. L'objectif de cette recherche est de comprendre comment les responsables publics prennent en charge concrètement le devoir de performance. Il s'agit de décrire à la fois les conceptions qu'ils s'en font et d'identifier les outils de gestion censés y conduire. Pour atteindre cet objectif, la recherche se concentre sur les établissements publics de coopération intercommunale (EPCI) à fiscalité propre institués depuis 1999. Ces organisations ont récupéré les principales compétences traditionnellement dévolues aux communes, dans le but d'en optimiser la gestion et de réaliser des économies d'échelle. Elles constituent de ce fait le lieu privilégié pour l'éwtude du management de la performance dans le secteur public local. Deux études de cas ont été menées, s'appuyant sur 47 entretiens semi-directifs. Elles décrivent de manière transversale les outils de gestion utilisés dans les services opérationnels et fonctionnels. Ce faisant, l'architecture globale du système de management de la performance de l'organisation est reconstituée et permet d'identifier les valeurs centrales. Les résultats révèlent que, contrairement à une idée répandue, les responsables intercommunaux ont de longue date été confrontés à l'exigence de performance. Ils mobilisent cette expérience en développant des stratégies de bricolage et d'appropriation des outils de gestion. Elles visent tant à ancrer les outils dans les pratiques qu'à soumettre au débat la normativité qu'ils véhiculent. En résultent des systèmes de management de la performance fragmentaires, dont la principale mission est d'exercer les responsables à l'art du compromis entre des exigences contradictoires.

<p>Old people's life situation when receiving municipal help and care in theirlast period of life is sparsely investigated from their own perspective. Thepurpose of this study was focused on the thoughts of the aged people andtheir personal experiences on what quality is within the geriatric care. Inthis qualitative study, 10 elderly people aged 75-90 years wereinterviewed from 3 different nursing homes within Solna Municipality.Qualitative interviews, with the emphasis on their present life situationespecially what brought about a good life, were performed. The interviewswere analysed using qualitative content analysis. The implication of theterm “meaningful existence” is individual and differs from person toperson. This study has identified six categories that could lead to ameaningful existence for the elderly living in nursing homes. These were:to feel secure, maintaining self determination, maintaining relations, to berespected, to feel comfort and to be active. In conclusion it was found thata meaningful existence, what ever it may be to the single individual, isimportant the quality of life for the elderly person residing in nursing homes.</p>

Gegenstand der Untersuchung ist die Umsetzung der europäischen, gleichstellungspolitischen Strategie Gender Mainstreaming (GM) in der Ministerialverwaltung des neuen EU-Mitgliedslands Estland. GM hat die Umsetzung der Gleichstellung von Männern und Frauen zum Ziel und wird als eine Querschnittsaufgabe mit Instrumenten der Verwaltungsmodernisierung (Folgenabschätzung, Wissensmanagement, u.a.) umgesetzt. Wie diese Strategie in der Ministerialverwaltung als ausführendes Organ der Regierung aufgenommen, übersetzt und umgesetzt wird in einem Land, das viele Jahrzehnte dem kommunistischen Gleichheitspostulat unterworfen war und als Staatsneugründung seine nationale Verwaltung erst aufbauen musste, wird in der Arbeit beschrieben und analysiert. Die Dissertation ist in vier Teile gegliedert: in Teil I wird in den Untersuchungsgegenstand und die Methode der Arbeit eingeführt. Teil II beschreibt die gesellschaftlich-politischen und administrativen Rahmenbedingungen im Fallbeispiel Estland. Teil III widmet sich dem Untersuchungsgegenstand „Umsetzung von GM in der estnischen Ministerialverwaltung“. Der IV. Teil beschließt die Arbeit mit der Analyse der Zusammenhänge zwischen den Rahmenbedingungen und der Umsetzung. Teil I beginnt mit der Darstellung des Forschungskonzepts, das sich aus Elementen der Verwaltungswissenschaft und der Forschung zu staatlichen Strukturen für Gleichstellungspolitik, einem Zweig der politikwissenschaftlichen Geschlechterforschung, zusammensetzt. Damit wird für die Untersuchung von GM erstmals systematisch die Verwaltungswissenschaft herangezogen. Die Arbeit wird methodisch und theoretisch als explorativ-explanative Single Case Studie verortet, die sich an neo-institutionalistischen Ansätzen orientiert. Teil II der Arbeit führt in das Fallbeispiel Estland ein: Es werden drei identifizierte Interpretationsmuster dargestellt anhand derer in Estland die Vergangenheit als besetzte Nation und die Gegenwart als demokratischer Staat (re )konstruiert werden und die das estnische, kollektive Selbstverständnis prägen. Anschließend werden die gesellschaftlichen und administrativen Rahmenbedingungen und Einflussfaktoren beschrieben, die für die Umsetzung von Querschnittsreformen in der öffentlichen Verwaltung und für die Umsetzung von Gleichstellungspolitik von Bedeutung sind. Die Forschungsergebnisse in Teil II zeigen über die empirischen Befunde hinaus, dass Estland nicht immer eindeutig in klassische politikwissenschaftliche Kategorien einzuordnen ist. Sowohl die Transitionssituation des Landes als auch die an westlichen Demokratien ausgerichteten Untersuchungskriterien sind für diesen Befund ursächlich. Teil III der Arbeit widmet sich dem Untersuchungsgegenstand GM. Nach grundlegenden Informationen zu dieser Verwaltungsmodernisierungsstrategie folgt die Darstellung der Umsetzung in der estnischen Ministerialverwaltung. In Teil IV der Dissertation werden die in Teil II beschriebenen Variablen auf die Umsetzung von GM (Teil III) bezogen. Die Analyse erfolgt anhand von Kriterien, die sich aus der Auswertung internationaler GM-Implementierungserfahrungen ergeben. Die Untersuchung zeigt, dass das post-kommunistisch geprägte, gesellschaftliche Klima besondere Legitimitätsprobleme für eine an Gleichheit orientierte staatliche Politik schafft. Dies kann die schwache zivilgesellschaftliche gleichstellungspolitische Lobby nur sehr begrenzt beeinflussen. Die strukturellen Bedingungen der estnischen Ministerialverwaltung mit ihrer geringen Koordinationsfähigkeit und politischen Steuerbarkeit machen eine effektive Umsetzung von Querschnittsreformen allgemein schwierig. Als produktiv für die Umsetzung hat sich der hohe Grad der fachlichen Professionalität und Politikversiertheit der kleinen, gleichstellungspolitischen Elite in der Ministerialverwaltung herauskristallisiert. Über Kooperationen mit internationalen Akteuren und estnischen zivilgesellschaftlichen Kräften sowie einzelnen interessierten Personen in der Verwaltung treibt sie die Umsetzung von GM voran. Sie nutzte die EU-Beitrittsverhandlungen um politischen Handlungsdruck für die Verwaltungsmodernisierung durch GM aufzubauen. Nachdem dieser seit dem Beitritt nicht aufrecht erhalten werden kann, zeichnet sich eine neue Umsetzungsstrategie ab. Es wird zukünftig nicht mehr vor allem an den normativen und kognitiven Strukturen in der Verwaltung, also den Einstellungen und Fachkompetenzen des Verwaltungspersonals zu gleichstellungsorientierter Arbeit, angesetzt. Vielmehr sollen neue, gleichstellungsrelevante Wissensbestände durch Expertinnen und Experten und exponierte Persönlichkeiten in die Gesellschaft und die Verwaltung transportiert und damit grundlegende gesellschaftlich-normative Voraussetzungen für die Rezeptivität von GM verbessert werden. / The object of research is the implementation of the European equal opportunities policy ‘gender mainstreaming’ (GM), in the ministerial administration of the new European Union member state Estonia. GM is a transversal task that employs the instruments of administration modernisation (impact assessment, knowledge management and others), its aim is equal opportunities for men and women at all levels. This paper describes and analyses how GM strategy is received, interpreted and implemented by the ministerial administration, as executive body of government, in a country that has had to rebuild its national administration following years of subjugation to the communist egality postulate. The dissertation is divided into four parts. Part I introduces the research object and methodology. Part II describes the socio-political and administrative framework of the case example Estonia. Part III is devoted to the research object ‘Implementation of GM in the Estonian ministerial administration’. Part IV concludes the paper with an analysis of the correlations between the socio-political parameters and the implementation. Part I begins with the presentation of the research concept that comprises elements from Public Administration and research on state structures for equal opportunities policy, a field of gender studies in political science. This means that for the first time the science of public administration is being systematically applied to GM research. The research employs explorative/explanative single case study methods and theory in accordance with neo-institutionalism approaches. Part II introduces the case study Estonia describing three identified interpretation models on the basis of which Estonia is (re)-constructing its past as an occupied nation and the present day as a democratic state, and which characterise Estonian national identity. Finally, an account is given of the social and administrative parameters and the influencing factors significant for the implementation of both transversal reforms in public administration and equal opportunities policies. Research results in part II go beyond the empirical findings and show that Estonia cannot always be conclusively classified within standard political science categories. This is due both to the country’s transitional situation as well as to research criteria that are tailored to Western democracies. Part III is devoted to the research object GM. Key information on this modernisation strategy is followed by a report on its implementation in the Estonian ministerial administration. In part IV of the dissertation the variables described in part II are related to the implementation of GM (part III). This analysis is carried out on the basis of criteria resultant from the evaluation of international experience of GM implementation. The research shows that the social climate of the post-communist era generates specific legitimacy problems for a national policy based on equality, upon which the powerless equal opportunities lobby in civil society has only limited influence. The structural conditions in the Estonian ministerial administration, with their limited coordinating ability and political governance, render effective implementation of transversal reforms generally quite difficult. It has emerged that the small equal opportunities 'elite' in the ministerial administration with their high degree of professionalism and political experience is /the /crucial factor for the GM implementation process. Through cooperation with international players and powers within Estonian civil society, as well as interested individuals in the public administration, they are able to keep implementation of GM going. They used EU-membership negotiations to build political pressure to modernise the public administration with GM. Following EU-membership this could not be sustained and a new implementation strategy is now beginning to emerge. In future, efforts will no longer be concentrated mainly on the normative and cognitive structures in the administration, meaning the attitudes and professional competences of the administrative staff with regard to equal opportunities. Instead, the intention is to transport new corpuses of knowledge relevant to equal opportunities into society as a whole, and public administration in particular, by experts and persons in exposed positions. In this way the elite expects fundamental socio-normative preconditions for receptivity of GM to be influenced for the better.

En kvalitativ intervjustudie har genomförts på fem vårdcentraler i Stockholms län där syftet var att undersöka om nio distriktssköterskor upplever att deras psykosociala arbetsmiljö har förändrats sedan införandet av Vårdval Stockholm. Jag ville också undersöka hur de i sådana fall upplevde att det har förändrats, om det fanns skillnader i denna upplevelse beroende på i vilket socioekonomiskt område de arbetar inom samt hur förändringarna skiljer sig från effekter av tidigare vårdreformer. Eftersom Vårdvalsreformen infördes i årsskiftet 2007/2008 finns det knappt någon forskning om denna reform och därför skulle den här studien kunna bidra med intressanta resultat. Teorier och tidigare forskning behandlar psykosocial arbetsmiljö, arbetsmiljöns utveckling under 1990-talet inom välfärdstjänsteområdet samt effekter av ett New Public Management-inspirerat styrsystem på sjukvårdens arbetsmiljö. Resultaten av den här studien visar att på alla vårdenheter upplever respondenterna en förändring i den psykosociala arbetsmiljön efter införandet av Vårdval Stockholm som ofta uttrycks som en utveckling åt det sämre, men förändringen är olika stor på de olika vårdenheterna. De största förändringarna har skett i området Sydvästra 1 och i Innerstadsområdet, medan Norrortsområdet tycks ha påverkats minst. Förändringarna tar sig uttryck i minskade resurser, främst i form av personal som leder till stress och ohälsa. Detta gäller dock inte alla enheter. Tidsbristen leder till ett minskat socialt stöd vilket bidrar till minskad arbetsglädje. Nya krav anses främst felaktiga och svåra att hantera, dessutom undergräver de det egentliga distriktssköterskearbetet. I det empiriska materialet finns det inga skillnader i deras upplevelser som enligt denna studiens omfattning kan förklaras av den socioekonomiska situationen i de olika områdena. Det är inte mycket i resultaten som verkar skilja sig från situationen under 1990-talet och alltså därmed från effekter av tidigare vårdreformer. Därför är det svårt att avgöra om de upplevda förändringarna beror på Vårdvalet, om de förstärkts av Vårdvalet eller om de inte alls påverkas av reformen.

Old people's life situation when receiving municipal help and care in theirlast period of life is sparsely investigated from their own perspective. Thepurpose of this study was focused on the thoughts of the aged people andtheir personal experiences on what quality is within the geriatric care. Inthis qualitative study, 10 elderly people aged 75-90 years wereinterviewed from 3 different nursing homes within Solna Municipality.Qualitative interviews, with the emphasis on their present life situationespecially what brought about a good life, were performed. The interviewswere analysed using qualitative content analysis. The implication of theterm “meaningful existence” is individual and differs from person toperson. This study has identified six categories that could lead to ameaningful existence for the elderly living in nursing homes. These were:to feel secure, maintaining self determination, maintaining relations, to berespected, to feel comfort and to be active. In conclusion it was found thata meaningful existence, what ever it may be to the single individual, isimportant the quality of life for the elderly person residing in nursing homes.

The group of elderly people in Sweden will increase significantly in the future and science point out that the future elderly people will not accept today’s standards and offers of assistance in today’s public elderly care. Therefore public elderly care stands before a significant challenge in terms of development that has to be sustainable. New research also points out that middle managers can be a great strategic resource, and a founder of success, in the challenge of sustainable development. The aim of the report was to increase the knowledge about what middle managers in public elderly care think sustainable development has to embrace, when it comes to quality and personnel administration, in order to meet the needs of the future elderly people. The aim was also to deepen the knowledge of how formal and informal organizational factors facilitate or limit middle managers possibilities to work with development in general and sustainable development in specific in their units. Interviews, as a qualitative method, were used to gather empirical data and the result was analyzed with theories as Domain theory, New Public Management and Situational leadership. Our findings showed that middle managers have little possibilities to work with sustainable development in their units and that formal factors as budget had a great impact of the middle managers overall possibilities in their work. According to the result it seemed that development and long term planning in this particular organization were tasks mainly for the management and political domain. According to our findings it seemed as if the introduction of New Public Management increased the underlying initial problems of human service organizations. According to Domain theory these problems consists of disjunction, discordance and conflicts due to the differences between the three domains when it comes to principles, success measures, structure and work modes.

No description available.

The police organization is a link to the executive organizations of the government. It is the closest, most direct and most frequently used bridge between the government and the public. Therefore, on the one hand, the police organization has to bear its responsibilities in handling the problems of social order; on the other, greater efforts should be made to maintain good service. In order to pursue a balanced development of these two aspects and to face the new challenges in future management, the National Police Administration starts to promote the import of ISO9001 Quality Management System to police organizations. The Nantzu Police Precinct is the first to import this System. Through investigation and analysis of the certification process and the achievements of the police precinct, this research hopes to provide other police organizations with the transfer of this system and a deepening direction. The research results show that through the policeman¡¦s cognitive degree of ISO9001, the attribute of the basic personal background of a police officer affects the officer¡¦s verification effects of ISO9001. After analysis is made regarding the question of cognitive degree of ISO9001, it is found that the cognitive degree of ISO9001 has 3 factors of composition construct: ¡§cognition,¡¨ ¡§attitude¡¨ and ¡§confidence.¡¨ The results indicate that different attributes of the basic personal backgrounds of police officers can develop different factors of composition constructs of their cognitive degrees of ISO9001. And there exists an obvious relation between the attributes of the basic personal background of police officers and the groups with high and low cognitive degrees of ISO9001. In addition, factor analysis is made on the question of the verification effects of ISO9001. It is found that there are 3 index kinds of verification effects of ISO9001: ¡§efficiency,¡¨ ¡§effectiveness¡¨ and ¡§quality.¡¨ Through typical relativity analysis, the results show there is an obvious relation between the composition construct of the cognitive degrees of ISO9001 and the index kinds of verification effects of ISO9001. In the groups with high and low cognitive degrees of ISO9001, the index kinds of verification effects of ISO9001 are different. Among the police officers with different attributes of basic personal backgrounds, the index kinds of verification effects of ISO9001 are also different. After the relevant analyses are made, the results reveal that there is an obvious positive correlation between the various factors of composition construct of the cognitive degrees of ISO9001 and the index kinds of verification effects of ISO9001. The research results prove that the high and low cognitive degrees of ISO9001 can positively affect police officers¡¦ promotion of the verification effects of ISO9001. Starting from literature reviews, the difficulties found in the importing process of ISO System, and the significant affecting factors of its success and failure, the researcher makes synthesis and integration, proposes for police organizations the workable strategies of transfer and deepening in times of importing ISO Quality Management System, and suggests the future research directions.