Understanding the wide range of outcomes achieved by firms trying to implement TQM and similar process improvement initiatives presents a challenge to management science and organization theory: a few firms reap sustained benefits from their programs, but most efforts fail and are abandoned. A defining feature of such techniques is the reliance on the front-line workforce to do the work of improvement, thus creating the possibility of agency problems; different incentives facing managers and workers. Specifically, successfully improving productivity can lead to lay-offs. The literature provides two opposing theories of how agency interacts with the ability of quality-oriented improvement techniques to dramaticlly increase productivity. The 'Drive Out Fear' school argues that firms must commit to job security, while the 'Drive In Fear' school emphasizes the positive role that insecurity plays in motivating change. In this study a contract theoretic model is developed to analyze the role of agency in process improvement. The main insight of the study is that there are two types of job security, internal and external, that have opposite impacts on the firm's abilty to implement improvement initiatives. The distinction is useful in explaining the results of different case studies and can reconcile the two change theories. / National Science Foundation, grant SBR-9422228, the Ford Motor Company and the Harley-Davidson Motor Company. MIT Sloan School of Management, Center for Innovation in Product Development

This is a dissertation about customer focus. Customer focus is a concept that can be understood in terms of giving the customer what the customer wants. It has been argued that the industrial society has transformed into a service society with the obvious consequence that services nowadays play a leading part, not at least in regard to customer focus. The customer of today is claimed to have lost interest in mass consumption and is much attracted to personalized and unique solutions, something that results in the fact that businesses must create or develop customer focus, i.e. listen to the customer’s wishes, needs, and demands. According to most researchers in this field, “service excellence” is the primary aspect one firm can use in order to successfully compete with other similar firms. According to Service Management, customer focus is much about developing a personal relationship between the service provider (employee) and the customer. In order to that, the service provider needs to adjust his or hers behaviour in accordance with the customer. This circumstance has a tendency to lead to a “master-and-servant” relation, in which the service provider must obey the various wishes, needs, and demands any customer may have. Most studies on customer focus have been undertaken in the context of low skill service work, but the results have often (implicitly) been generalized to comprise all service work in the whole service sector. As a consequence of this situation, my survey takes on high skill service work (banking and health care). The main purpose of the survey is to examine if the results and analyses, presented from service management apply when the services are not low skill. The results from this survey shows that Service Managements heavily emphasis of the personal relationship between employee and customer – in which the service provider in some meaning need to undertake the role of a servant – can be questioned. The results also show that there is a discrepancy between (bank customers’ and patients’) opinion on an abstract comprehensive level and a specific level where various situations and errands are defined. Further, the dissertation shows that the various factors that can be included in the conception of customer focus, need to be examine more carefully. Some factors integrate in a way that makes it difficult to separate them, and one specific factor can in fact hold a variety of essences.

Work-related activation policies are currently developing in most western welfare states. Sweden is no exception and activation policies were introduced in the 1990s in many municipal social services organizations in Sweden. The Swedish form of activation policies requires social assistance recipients to participate in mandatory activation program in return for financial support. This dissertation investigates the street-level implementation practices of activation policies within the context of the Swedish welfare state. The purpose of the study is to examine how street-level workers in the municipal social service systemtranslate activation policy into practice in their interactions with the clients and what factors that structure their implementation practices. The research project is a multiple-case study that examines the street-level practices in two municipal social service settings in Sweden, Skärholmen city-district in Stockholm municipality and Osby municipality and their local activation programs. The data collection consists of observations of the staffs’ daily operations, interviews with local politicians and other key personnel, and the analysis of formal policy and program documents. Theoretically this dissertation builds on the street-level bureaucracy perspective (Lipsky, 1980), which suggests that organizational working conditions shape street-level workers implementation practices through their development of informal coping strategies. But this study extends the street-level buraucracy approach by including political-institutional factors and normative assumptions about public support and social assistance recipients into the analysis. Findings from the study suggest that street-level implementation practices entail a number of informal coping strategies that removes activation policy from formal policy goals. Implementation practices entail, for example, mass referrals instead of individual assessments and tailor-made solutions. Clients were sorted and categorized on the basis of moral perceptions about behavioral deficits instead of employment needs. These informal practice strategies were the results of both coping strategies and normative assumptions that interacted with the organizational context in which these practices took place.

The research was directed at assessing the strengths and weaknesses in the application-to-approval process of social grants up to the payment of social grants at pay-points in the South African Social Security Agency (hereafter SASSA). The general aim of the research project was to assess the application-to-approval process of grant administration in SASSA up to the payment of social grants at pay-points. The specific objectives of the study were therefore: * To describe the current application-to-approval process of grant administration; * To assess the strengths and weaknesses in the grant administration process of specified administrative procedures and structural issues as perceived by attesting officials (front-line staff responsible for taking down the grant applications), data-capturer officials (staff responsible for capturing the information on the application form onto the SOCPEN system, pay-point team members (staff responsible for rendering services at pay-points) and beneficiaries at pay-points; and * To provide a report on the strengths and weaknesses of the grant administration process from application to pay-out to the top management of SASSA. The study was conducted in two regions, namely the Northern Cape and the Western Cape. Various offices in the Northern Cape and the Western Cape were therefore part of the research. The grant administration process from application-to-approval includes various stages. The staff members include the screening official (step one) who checks the completeness of the required documentation, followed by attesting official (step two) who takes down the application and captures it on SOCPEN and then forwards it to the next level, namely quality control (step three). Thereafter a verifying official verifies the information captured on SOCPEN against documentation submitted and approves or rejects the application on SOCPEN (step four). Staff at pay-points (where beneficiaries receive their payments) and beneficiaries at pay-points were also part of the research focus. Four different data-collection instruments were therefore used during the research project. The first data-collection instrument was designed to collect data on the actual grant application process and problems and strengths in this regard (questionnaire front-line staff). The empirical investigation revealed the following with regard to the front-line staff: * The majority of front-line staff have considerable working experience (more than five years) in SASSA; * The majority of front-line staff have inadequate work space; * Training, supervision and mentoring support from supervisors and colleagues occurs haphazardly; * The majority of front-line staff receive between 11-29 applications per day and spent 30 minutes or less to take down an application; * Policy documents that regulate the implementation of new policy changes are not always available; * Grant application files get misplaced or lost after processing; * Staff carelessness is one of the main reasons why files get lost or misplaced and * Front-line staff experience technical difficulties with the computer on a regular basis and it takes one to three days to resolve technical difficulties. The second data-collection instrument was developed to collect data on the capturing of the application (questionnaire data-capturer) onto the SOCPEN system. The empirical investigation revealed the following with regard to data-capturers: * The majority of data-capturers have solid work experience as data-capturers in SASSA although some data-capturers have inadequate work space; * Training on the implementation of new policy changes occurs irregularly; * Supervision, mentoring and support from supervisors happen haphazardly; * Data-capturers receive between 20 and 29 applications per day and they capture all applications successfully; * Data-capturers receive support from colleagues on a more regular basis than from supervisors; * Documents or guidelines that regulate the implementation of policy changes are not always available in the work place; * Applications sometimes get misplaced or lost after capturing; * No proper mechanisms are in place to record the movement of files, staff carelessness and either lack of office space or filing space, are the main reasons why applications get lost or misplaced; * Data-capturers sometimes experience technical problems with computers and it takes one to less than five days to resolve technical difficulties; * Data-capturers receive sometimes incomplete applications from the attesting officials (those staff officials who are responsible for taking down the application) and they usually take such applications back to the first attesting officer; * Backlogs in the capturing and approving of normal applications exist and staff shortages and system-related problems are the main reasons why backlogs exist; * Backlogs exist with regard to the capturing and approving of review cases and * Staff shortages, a centralized review management approach, lack of office space and lack of connectivity points constitute the main reasons why review backlogs exist. The third data-collection instrument (questionnaire pay-point team member) was developed to measure services at pay-points and to determine the problems experienced at pay-points. The empirical investigation revealed the following with regard to this category as seen by pay-point team members: * Some pay-points are not disabled-friendly; * There are not always enough chairs, toilet facilities or drinking water available at pay-points; * Payment contractors and SASSA staff sometimes arrive late at pay-points; * Payments are usually delayed between 15 minutes to less than an hour, but beneficiaries are not always informed about delays; * There are sometimes broken machines at pay-points and this causes 15 to 45 minutes delay in payments; * There is not always enough money at pay-points and it takes an hour to just under two hours to get more money; * Grant recipients hardly ever receive wrong grant amounts; * Hawkers and vendors operate mainly outside the pay-point; * Security guards are available at pay-points and there is access control at pay-points (mainly driven by security guards from the payment contractor) * Not all pay-points are fenced all round and * First Aid kits are available at pay-points most of the time. The fourth data-collection instrument (questionnaire for beneficiaries) was developed to target the beneficiaries who receive grant payments at pay-points. The empirical investigation revealed the following: * Some pay-points are not disabled-friendly; * There are not always enough chairs, toilet facilities or drinking water available at pay-points; * Payment contractors and SASSA staff sometimes arrive late at pay-points; * Payments are usually delayed between 15 minutes to less than an hour, but beneficiaries are not always informed about delays; * There are sometimes broken machines at pay-points and this causes 15 to 45 minutes‟ delay in payments; * There is not always enough money at pay-points and it takes an hour to less than two hours to get more money; * Grant recipients rarely receive wrong grant amounts; * Hawkers and vendors operate mainly outside the pay-point, but there are exceptional cases where they operate inside the pay-points; * Beneficiaries do feel safe at pay-points most of the time; * Beneficiaries mostly live within walking distance from the pay-point; * Beneficiaries hardly experience problems at pay-points and if they do, their problems get resolved; * Not all pay-points provide shelter from the elements; * Beneficiaries are satisfied with the services SASSA renders and the grant has improved their quality of life. Grant administration processes in SASSA are labour-intensive and officials play a vital role in the correct administration of social grants. The study has revealed that although there is clearly some strength in the grant administration process from application-to-approval up the payment of social grants at pay-points, it is unfortunately true that the weaknesses are overwhelming. / Thesis (PhD (Social Work))--North-West University, Potchefstroom Campus, 2013

The research was directed at assessing the strengths and weaknesses in the application-to-approval process of social grants up to the payment of social grants at pay-points in the South African Social Security Agency (hereafter SASSA). The general aim of the research project was to assess the application-to-approval process of grant administration in SASSA up to the payment of social grants at pay-points. The specific objectives of the study were therefore: * To describe the current application-to-approval process of grant administration; * To assess the strengths and weaknesses in the grant administration process of specified administrative procedures and structural issues as perceived by attesting officials (front-line staff responsible for taking down the grant applications), data-capturer officials (staff responsible for capturing the information on the application form onto the SOCPEN system, pay-point team members (staff responsible for rendering services at pay-points) and beneficiaries at pay-points; and * To provide a report on the strengths and weaknesses of the grant administration process from application to pay-out to the top management of SASSA. The study was conducted in two regions, namely the Northern Cape and the Western Cape. Various offices in the Northern Cape and the Western Cape were therefore part of the research. The grant administration process from application-to-approval includes various stages. The staff members include the screening official (step one) who checks the completeness of the required documentation, followed by attesting official (step two) who takes down the application and captures it on SOCPEN and then forwards it to the next level, namely quality control (step three). Thereafter a verifying official verifies the information captured on SOCPEN against documentation submitted and approves or rejects the application on SOCPEN (step four). Staff at pay-points (where beneficiaries receive their payments) and beneficiaries at pay-points were also part of the research focus. Four different data-collection instruments were therefore used during the research project. The first data-collection instrument was designed to collect data on the actual grant application process and problems and strengths in this regard (questionnaire front-line staff). The empirical investigation revealed the following with regard to the front-line staff: * The majority of front-line staff have considerable working experience (more than five years) in SASSA; * The majority of front-line staff have inadequate work space; * Training, supervision and mentoring support from supervisors and colleagues occurs haphazardly; * The majority of front-line staff receive between 11-29 applications per day and spent 30 minutes or less to take down an application; * Policy documents that regulate the implementation of new policy changes are not always available; * Grant application files get misplaced or lost after processing; * Staff carelessness is one of the main reasons why files get lost or misplaced and * Front-line staff experience technical difficulties with the computer on a regular basis and it takes one to three days to resolve technical difficulties. The second data-collection instrument was developed to collect data on the capturing of the application (questionnaire data-capturer) onto the SOCPEN system. The empirical investigation revealed the following with regard to data-capturers: * The majority of data-capturers have solid work experience as data-capturers in SASSA although some data-capturers have inadequate work space; * Training on the implementation of new policy changes occurs irregularly; * Supervision, mentoring and support from supervisors happen haphazardly; * Data-capturers receive between 20 and 29 applications per day and they capture all applications successfully; * Data-capturers receive support from colleagues on a more regular basis than from supervisors; * Documents or guidelines that regulate the implementation of policy changes are not always available in the work place; * Applications sometimes get misplaced or lost after capturing; * No proper mechanisms are in place to record the movement of files, staff carelessness and either lack of office space or filing space, are the main reasons why applications get lost or misplaced; * Data-capturers sometimes experience technical problems with computers and it takes one to less than five days to resolve technical difficulties; * Data-capturers receive sometimes incomplete applications from the attesting officials (those staff officials who are responsible for taking down the application) and they usually take such applications back to the first attesting officer; * Backlogs in the capturing and approving of normal applications exist and staff shortages and system-related problems are the main reasons why backlogs exist; * Backlogs exist with regard to the capturing and approving of review cases and * Staff shortages, a centralized review management approach, lack of office space and lack of connectivity points constitute the main reasons why review backlogs exist. The third data-collection instrument (questionnaire pay-point team member) was developed to measure services at pay-points and to determine the problems experienced at pay-points. The empirical investigation revealed the following with regard to this category as seen by pay-point team members: * Some pay-points are not disabled-friendly; * There are not always enough chairs, toilet facilities or drinking water available at pay-points; * Payment contractors and SASSA staff sometimes arrive late at pay-points; * Payments are usually delayed between 15 minutes to less than an hour, but beneficiaries are not always informed about delays; * There are sometimes broken machines at pay-points and this causes 15 to 45 minutes delay in payments; * There is not always enough money at pay-points and it takes an hour to just under two hours to get more money; * Grant recipients hardly ever receive wrong grant amounts; * Hawkers and vendors operate mainly outside the pay-point; * Security guards are available at pay-points and there is access control at pay-points (mainly driven by security guards from the payment contractor) * Not all pay-points are fenced all round and * First Aid kits are available at pay-points most of the time. The fourth data-collection instrument (questionnaire for beneficiaries) was developed to target the beneficiaries who receive grant payments at pay-points. The empirical investigation revealed the following: * Some pay-points are not disabled-friendly; * There are not always enough chairs, toilet facilities or drinking water available at pay-points; * Payment contractors and SASSA staff sometimes arrive late at pay-points; * Payments are usually delayed between 15 minutes to less than an hour, but beneficiaries are not always informed about delays; * There are sometimes broken machines at pay-points and this causes 15 to 45 minutes‟ delay in payments; * There is not always enough money at pay-points and it takes an hour to less than two hours to get more money; * Grant recipients rarely receive wrong grant amounts; * Hawkers and vendors operate mainly outside the pay-point, but there are exceptional cases where they operate inside the pay-points; * Beneficiaries do feel safe at pay-points most of the time; * Beneficiaries mostly live within walking distance from the pay-point; * Beneficiaries hardly experience problems at pay-points and if they do, their problems get resolved; * Not all pay-points provide shelter from the elements; * Beneficiaries are satisfied with the services SASSA renders and the grant has improved their quality of life. Grant administration processes in SASSA are labour-intensive and officials play a vital role in the correct administration of social grants. The study has revealed that although there is clearly some strength in the grant administration process from application-to-approval up the payment of social grants at pay-points, it is unfortunately true that the weaknesses are overwhelming. / Thesis (PhD (Social Work))--North-West University, Potchefstroom Campus, 2013

Abstract Essay in political science, C-level, by Line Säll, spring semester 2007. Tutor: Susan Marton. ”To do things by the rule of law -A study in the discretion of front-line bureaucrats” This essay has it´s starting-point in the theoretical problem of social science to unite democracy and bureaucracy. The purpose is to illustrate the problems with the discretion of front-line bureaucrats in a democratic state. The theoretical approach is front-line bureaucracy-theory. Certain characteristics of the work of street-level bureaucrats makes it impossible to severly reduce discretion. The thesis is that the public policy in important ways is made in the offices of street-level bureaucrats because of their discretion. My research question is: How does front-line bureaucrats, at an employment exchange office in Sweden, interpret their discretion? The discretion is investigated in relation to the marginalised position of immigrants on the swedish labor-market, and in the perspective of that the swedish population is getting more and more heterogeneous. The essay is an qualitative interview study, as front-line bureaucrats at an employment exchange office has been interviewed. My findings is that the front-line bureaucrats interpret their discretion as quite limited. The limits is mostly seen in relation to the rules of the organisation, the bureaucrats orientation towards the organisation over the client and to the ideal of the rule of law.

Denna studie av första linjens situationsanpassade ledarskap uppvisar mångalikheter mellan respondenternas beslutsfattande, nivå av anpassningsbarhet ocheffektivitetsvärdering uppmätta efter Hershey och Blanchards ledarskapsmodell(SLT-Modellen) trots deras vitt skilda verksamhetsområden med första linjensoperativa ledarskap som gemensam nämnare.Denna studie påvisar att utifrån SLT-modellen och studiens respondenter att derasledarskap i första hand inte påverkas av de varierande organisationsstrukturella,kulturella eller geografiska miljöer de verkar i, utan främst av faktorer tillhörande ensituationsanpassad och aktivitetsstyrd verksamhet under med inslag av hög stressoch risk med tydliga regelverk. Studien påvisar likande resultat i ledarskapsstilar,effektivitet m.fl. som tidigare undersökning av polisära ledare som genomförts itidigt 1980-talets USA, trots de samhällsförändringar som skett under en tidsperiodav 40-år samt de geografiska och kulturella skillnader mot denna studiesrespondenter som uteslutande består av svenska individer, dock verksamma på eninternationell arena.Vidare bestyrker föreliggande studie den kritik av tidigare forskning av SLTmodellen, är frånvaro av laissez-faire ledarstilen. Dock framgår frånintervjufrågeställningarna att begräsningarna inte ligger hos de underställdasmognadsfas, engagemang eller vilja utan snarare inom ett verksamhetens specifikaområde med faktorer som ansvar, regelverk och aktivitetsbaserade uppdrag. Givet ien friare och mer oreglerad verksamhet skulle möjligtvis SLT-modellen nå längre.

Bakgrund: Genom tiderna har mänskligheten drabbats av flera pandemier. Den 11 mars 2020 förklarades Covid-19 som pandemi orsakad av viruset SARS-Cov-2. Pandemier påverkar både individer såväl som samhällen och kräver vanligtvis extraordinära insatser för att hindra smittspridning. Under pandemin har den svenska sjukvården har varit under hög belastning. Arbetsbelastningen och riskerna för att sjuksköterskor utsätts för hög stress ökar vid pandemier. Stressen kan komma att påverka sjuksköterskors hälsa negativt. Syfte: att beskriva sjuksköterskors upplevelser av att arbeta i frontlinjen under pågående Covid-19-pandemi och hur de upplever att detta påverkar deras hälsa. Metod: En systematisk litteraturstudie genomfördes för att besvara syftet. Totalt 13 artiklar har analyserats och användes som grund till litteraturstudiens resultat. Resultat: I resultatet framkom två kategorier; sjuksköterskans stärkta yrkesidentitet samt sjuksköterskans arbete i förändrad miljö. Ur dessa kategorier identifierades tre underkategorier vardera. Slutsats: Arbetet i frontlinjen innebär en påfrestande miljö för sjuksköterskor att arbeta i. Sjuksköterskorna påverkas både professionellt och privat under pandemin. Pandemin har tvingat hälso- och sjukvården till stora förändringar som har påverkat sjuksköterskor både positivt och negativt. Rädsla, stress och ångest förekommer men även en känsla av att tillhörighet och uppskattning under en påfrestande period. / Background Throughout the ages, humanity has been hit by pandemics. On March 11, 2020, Covid-19 was declared a pandemic caused by the SARS-Cov-2 virus. Pandemics affect both individuals and communities and usually require extraordinary efforts to prevent the spread of infection. The Swedish healthcare system has been under heavy pressure during the pandemic. The workload and the risks of nurses being exposed to high stress increase during pandemics. Stress can have a negative effect on nurses’ health. Aim: was to describe nurses’ experiences of working in the front line during the ongoing Covid-19 pandemic and the effect of nurses’ perceived health. Method: A systematic literature study was conducted to answer the purpose. A total of 13 articles have been analyzed and used as a basis for the results of the literature study. Result: The result emerged in two categories; nurses’ strengthened professional identity and nurses’ work in a changed environment. From these categories, three subcategories were identified each. Conclusion: The work in the front line means a stressful environment for nurses to work in. The nurses are affected both professionally and privately during the pandemic. The pandemic has forced the health service to make major changes that have affected nurses both positively and negatively. Fear, stress and anxiety occur but also a feeling of belonging and appreciation during a stressful period.

No description available.

Akutsjukvården i Sverige är en samhällsviktig verksamhet i vardag, kris och i händelse av krig. Den operativa ledningen på akutmottagningar sköts av en sjuksköterska med ledningsansvar, vars uppdrag är att leda och fördela arbetet under ett skift. På akutmottagningar i Sverige arbetar såväl tillsvidareanställd ordinarie personal med olika erfarenhetsnivå, liksom bemanningsanställd personal under förhållanden som kan definieras som påfrestande. Syftet med denna studie har varit att bidra med förståelse av ledarskap i akutsjukvårdens kontext genom att undersöka upplevelser av ledarskap av tillfälliga grupper under påfrestande förhållanden i rollen som ledningssjuksköterska. Med en kvalitativ ansats genomfördes sex semistrukturerade intervjuer med ledningssjuksköterskor från olika akutmottagningar i Region Stockholm. Resultatet analyserades genom en tematisk analys där en i Sverige etablerad ledarskapsmodell användes. Analysen genererade fyra teman som beskriver rollen och sammanhanget ledningssjuksköterskor verkar i, vad som kännetecknar påfrestande förhållanden i akutsjukvården och vilka omgivnings- och ledarfaktorer som påverkar ledarskapet hos ledningssjuksköterskor. Ett resultat av studien är en empirisk tillämpning av generell ledarskapsteori i akutsjukvårdens kontext. Studiens viktigaste bidrag är att ledningssjuksköterskor anpassar sitt ledarskap efter graden av påfrestning och personalgruppens kompetens, erfarenhet och behov av stöd. Resultatet indikerar också att kännedom om personalgruppens kompetens kan vara av särskilt betydelse under påfrestande förhållanden med tidsbrist, osäkerhet och psykiska påfrestningar som följd. / Emergency healthcare in Sweden holds a vital societal function in ordinary circumstances, crisis situations, and in the event of war. The operational management within emergency departments is lead by a nurse in charge, tasked with the responsibility of leading and allocating work during a shift. Within Swedish emergency departments there is a mix of permanently employed regular staff with varying levels of experience and temporary staff working under conditions that can be defined as demanding. The aim of this study has been to contribute to an understanding of leadership within the context of emergency healthcare by examining experiences of leadership of temporary groups during demanding conditions in the role of a charge nurse. A qualitative study involved conducting six semi-structured interviews with charge nurses from various emergency departments in the Stockholm Region. The results were analyzed using a thematic analysis utilizing a well-established leadership model in Sweden. This analysis generated four themes describing the role and context in which chargenurses operate, what characterizes demanding conditions in emergency healthcare, and which environmental and leadership factors affect the leadership of charge nurses. An outcome of the study involves the empirical application of general leadership theory. The primary contribution of this study is that charge nurses adapt their leadership based on levels of adversity and the competence, experience and support needs of the staff group. The results also suggest that awareness of the staff group’s competence can be particularly significant under demanding conditions, including time constraints, uncertainty and stress.