<p>The possibility to be able to better manage the Swedish public health care has been a focus from way back to the middle of the 20th century. This study focuses on a middle managerial position called Base-unit Executive Officer, which we feel is of great influence to the public health care. Because of the changes to the public health care organisations over a long period of time we find it important and interesting to research a managerial role in the midst of these changes. By going through information containing opinions, attitudes, and other information from employees within a CCDO we will try to enlighten what we feel are informational currents of opinions surrounding the notion of competence, leadership and management. The purpose of our study is to be able to help create an environment of open reflections and new ideas of what sort of competencies are required for the manager role.</p><p>The study is defined by our research problem which give use the following question:</p><p>What room is there for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer?</p><p>To be able to interpret the primary data of the study a theoretic framework was created in the purpose to function as a tool for continuation of the study. The study was done with the use of hermeneutical paradigm together with a compromise between deductive and inductive approach.</p><p>The primary data of the study was collected with a qualitative method through semi-structured interviews with six employees of whom three were Base-unit Executive Officers. The reason for the use of a qualitative method was that it gives us conditions to gather the opinions, thoughts, values etc. of the respondents.</p><p>By merging the tools of our theoretic framework and the collected data we were able to establish an analysis. We concluded that the analysis consisted of both congruence and discrepancy related to our theoretical framework. The discrepancy showed that there exist a room for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer. There is room to develop the comprehension of competence in areas such as management and leadership as defined by our theoretical framework.</p><p>Because of our path between deductive and inductive approach the reader should carefully evaluate the truth criteria in the study. Validation in the inductive sense is a tough task for a short and small study such as this one. We do however believe that give our preconditions have reached an acceptable level in the truth criteria. When taken into practical application we have hope that our initial thoughts of enlightment will enable a positive development of the managerial role of the Base-unit Executive Officers.</p>

The possibility to be able to better manage the Swedish public health care has been a focus from way back to the middle of the 20th century. This study focuses on a middle managerial position called Base-unit Executive Officer, which we feel is of great influence to the public health care. Because of the changes to the public health care organisations over a long period of time we find it important and interesting to research a managerial role in the midst of these changes. By going through information containing opinions, attitudes, and other information from employees within a CCDO we will try to enlighten what we feel are informational currents of opinions surrounding the notion of competence, leadership and management. The purpose of our study is to be able to help create an environment of open reflections and new ideas of what sort of competencies are required for the manager role. The study is defined by our research problem which give use the following question: What room is there for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer? To be able to interpret the primary data of the study a theoretic framework was created in the purpose to function as a tool for continuation of the study. The study was done with the use of hermeneutical paradigm together with a compromise between deductive and inductive approach. The primary data of the study was collected with a qualitative method through semi-structured interviews with six employees of whom three were Base-unit Executive Officers. The reason for the use of a qualitative method was that it gives us conditions to gather the opinions, thoughts, values etc. of the respondents. By merging the tools of our theoretic framework and the collected data we were able to establish an analysis. We concluded that the analysis consisted of both congruence and discrepancy related to our theoretical framework. The discrepancy showed that there exist a room for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer. There is room to develop the comprehension of competence in areas such as management and leadership as defined by our theoretical framework. Because of our path between deductive and inductive approach the reader should carefully evaluate the truth criteria in the study. Validation in the inductive sense is a tough task for a short and small study such as this one. We do however believe that give our preconditions have reached an acceptable level in the truth criteria. When taken into practical application we have hope that our initial thoughts of enlightment will enable a positive development of the managerial role of the Base-unit Executive Officers.

[pt] A presente dissertação de mestrado em metrologia relaciona- se à qualidade laboratorial do setor da saúde, notadamente da saúde pública, contribuindo para o desenvolvimento da confiabilidade metrológica do setor médico-hospitalar em pelo menos 4 aspectos básicos: (i) identificação da legislação metrológica disponível no Brasil, via de regra organizada de forma esparsa e não facilmente acessível ao profissional usuário final,cuja pesquisa bibliográfica explicita grande carência de literatura especializada; (ii) análise do acervo de normas e recomendações metrológicas para o setor; (iii)diagnóstico da qualidade laboratorial em um Laboratório Central de Saúde Pública (LACEN), como implementação de uma estratégia alternativa para implantação de sistema da qualidade em laboratório da saúde pública com base em uma nova abordagem que focaliza a qualidade laboratorial da Rede nacional de laboratórios Oficiais de Controle da Qualidade e Saúde, criando um mecanismo que permite ao laboratório demonstrar sua competência técnica; (iv) diagnóstico da conformidade metrológica de instrumentos médico-hospitalares fundamentado nos estudos de caso de balanças para controle da massa de neonatos e de instrumentos biomédicos para medição da pressão arterial, como exemplo de ação do controle metrológico de instrumentos de amplo uso no ambiente médico-hospitalar.A despeito da complexidade e abrangência do setor da saúde no Brasil, a pesquisa desenvolvida revelou não apenas carência e inadequação da literatura técnica disponível bem como forte vulnerabilidade no controle metrológico de laboratório e de equipamentos médico-hospitalares. O diagnóstico realizado em um laboratório típico da saúde pública evidenciou também grandes desafios para a implantação do sistema da qualidade laboratorial.A despeito dos complexos problemas de natureza política e econômica que afetam o sistema da saúde no Brasil, as limitações de caráter metrológicos relacionam-se (i) à falta de uma adequada cultura metrológica no setor, fator intrínseco que entrava a implementação do sistema da qualidade laboratorial, imprescindível à comprovação da competência técnica do laboratório (credenciamento) e (ii) uma surpreendente diversidade de modelos, tipos e quantidade de instrumentos/equipamentos em uso no setor, via de regra dependentes de calibração sofisticada que demandam complexa infra-estrutura laboratorial e métodos e práticas de calibração não disponíveis nos laboratórios credenciados que integram as redes laboratoriais implementadas no País. Sem a pretensão de exaurir tema de tal abrangência e complexidade, porém com o propósito de exemplificar duas importantes áreas que apresentam nítida vulnerabilidade em setores tradicionais cujo envolvimento metrológico não se constitui em barreira ao profissional- usuário do equipamento, a pesquisa analisou (a) o desempenho de dezesseis balanças disponíveis em seis hospitais maternidades, utilizadas para controle da massa de recém- nascidos, como estratégia de orientação do diagnóstico médico e (b)resultados do desempenho de esfigmomanômetros para controle da pressão arterial no ambiente hospitalar. O presente trabalho constitui parte de um esforço mais amplo, desenvolvido em articulação com a Agência Nacional de Vigilância Sanitária (ANVISA), para fortalecer a qualidade laboratorial no setor da saúde pública brasileira. / [en] The present dissertation for a Master`s degree in metrology is related to laboratory quality in the health care sector in general and to public health services in particular, and its purpose is to contribute to the development of reliable measurement practices in the hospital care section within the scope of at least 4 basic aspects: (i) identification of the available metrology legislation in Brazil which, as a rule, is sparsely organized and is not easily accessible to the end-user/practitioner, whose bibliographical research reveals an explicit lack of specialized literature; (ii) analysis of the compiled measurement standards and recommendations for the sector; (iii) diagnosis of laboratory quality in a Central Public Health Care Laboratory (Laboratório Central de Saúde Pública - LACEN)as a means by which to implement an alternative strategy for introducing a quality system in a public health care laboratory based on a new approach that focuses on the quality of the laboratories that comprise the National Network of Official Quality and Health Care Control Laboratories, and the subsequent creation of a type of mechanism that will allow a laboratory to demonstrate its technical competence; (iv) diagnosis of instruments that are employed in hospital services in terms of their conformity to measurement standards based on case studies of scales for controlling the mass of neonates, and of biomedical instruments for measuring blood pressure, as an example of how measurement is controlled in the case of instruments that are widely used in the hospital care environment.Despite the complexity and reach of the Brazilian health care sector, the research that was carried out not only revealed that the technical literature available is insufficient and unsuitable, but also that the measurement provided by laboratories and hospital care equipment are controlled in a high vulnerable manner. The diagnosis that was performed in a typical health care laboratory also brought to light a number of major challenges for the introduction of a laboratory quality system. Apart from the complex political and economic problems that affect the Brazilian health care system as a whole, the limitations associated with measurements are related to (i)the lack of a suitable metrology culture within the sector because this intrinsic factor hampers the implementation of a laboratory quality system and the latter is an essential requirement for proving that a laboratory is technically competent (accreditation), and (ii) the astonishing variety and number of models and types of instruments/equipment that are in use in this sector, which, as a rule, depend on sophisticated calibration procedures and require complex laboratory infrastructures and calibration methods and practices that are not available in the accredited laboratories within the laboratorynetworks that have been implemented in the country. This paper does not propose to exhaust such a broad and complex topic. Rather, its purpose is to consider the examples of two important areas that are clearly vulnerable in traditional sectors whose involvement with metrology does not represent an obstacle to the practitioner/user of the equipment. To this end, the research has focused on (a) the performance of sixteen scales that are available in six maternity hospitals and are used for controlling the mass of newborn infants as a strategy for the orientation of medical diagnoses and (b) the performance results of sphygmomanometers that are used for controlling blood pressure in hospital environments. This paper is part of a more encompassing initiative towards the improvement of laboratory quality in the Brazilian public health care sector and has been developed as a joint effort with the National Agency of Sanitary Vigilance (Agência Nacional de Vigilância Sanitária - ANVISA).

Den mänskliga resursen är en organisations viktigaste tillgång då organisationen är beroende av mänsklig aktivitet för att existera. Chefer blir i avseendet viktiga då de kan ses som organisationens företrädare samt då de bidrar till och formar processer och arbetsförhållanden. Det blir därav av vikt att skapa förutsättningar för dem att hantera sin roll och vilja stanna i den. Tidigare forskning visar att organisatoriska förutsättningar påverkar chefsrollen, men inte specifikt hur den organisatoriska kontexten får betydelse för deras intention att stanna i rollen. Syftet med den här studien är att undersöka hur första linjens chefers intention att stanna i rollen kan förstås utifrån den organisatoriska kontexten. Vidare är syftet att skapa förståelse för hur cheferna upplever sina förutsättningar att hantera rollen. För att besvara syftet har en kvalitativ metod i form av semistrukturerade intervjuer med första linjens chefer inom vården i offentlig sektor legat till grund för empiri. Resultatet visar att chefsrollen är komplex med förväntningar från flera håll, vilket tydliggör varför den organisatoriska kontexten är betydelsefull för att förstå chefernas upplevelser och deras intention att stanna i rollen. Ur chefernas berättelser kan uttydas att arbetstillfredsställelse och organisatoriskt engagemang är betydelsefullt, vilket främst härleds till den kliniska verksamheten och medarbetarna. Vidare framgår att organisatoriska förutsättningar som samspel, kommunikation och stöd får betydelse för hur de hanterar krav och förväntningar. Sammantaget bidrar studien till en ökad förståelse för hur en organisation, genom den organisatoriska kontexten, kan verka för att behålla första linjens chefer. / The human resource is an organization's most important asset as the organization depends on human activity to exist. In this reference, managers become important as they can be seen as the organization's representatives as well as they contribute to and shape processes and working conditions. It therefore becomes important to create an environment for them to manage their role and a will to stay in it. Previous research shows that organizational conditions affect the managerial role, but not specifically how the organizational context will have an impact on their intention to stay in the role. The aim of this study is to investigate how the first-line managers' intention to stay in their position can be understood from the organizational context. Furthermore, the aim is to develop an understanding of how the managers experience their ability to handle the role. To answer the aim, a qualitative method in the form of semi-structured interviews with first-line managers in public healthcare sector has been the source for empirical data. The result shows that the managerial role is complex with expectations from several directions, which explains why the organizational context is important for understanding the managers' experiences and their intention to stay in their position. From the managers' stories it can be read that job satisfaction and organizational commitment are important, which is mainly attributed to the clinical activities and the employees. Furthermore, it appears that organizational conditions such as interaction, communication and support will have an impact on how they handle requirements and expectations. In summary, the study contributes to an increased understanding of how an organization, through the organizational context, can work to retain first-line managers.