Titel: Sjukt omhändertagande - en studie om sjukfrånvaron inom den kommunala äldrevården Författare: Tuyet Pham, Hannes Skanung och Ida Söderman Handledare: Kjell Arvidsson Kurs: Företagsekonomi III - organisation, examensarbete (kandidat)   Syfte Vårt syfte med denna uppsats var att undersöka om den generellt höga sjukfrånvaron inom äldrevården i kommunal sektor har en organisatorisk koppling. I samband med uppsatsens syfte ställdes följande forskningsfråga: vilka organisatoriska faktorer bidrar till sjukskrivningarna inom den kommunala äldrevården?   Metod Denna studie är både en kvalitativ och kvantitativ studie som antagit en abduktiv ansats. Studien går under undersökningsdesignen fallstudie där det empiriska materialet består av en enkätundersökning samt kvalitativa intervjuer. I enkätundersökningen deltar 56 medarbetare och på intervjuerna deltar nio anställda på sex avdelningar under tre enheter.   Slutsatser Den empiriska och teoretiska datainsamlingen resulterade i slutsatsen att den generellt höga sjukfrånvaron inom den kommunala äldrevården har en organisatorisk koppling. Organisatoriska faktorer som vi anser påverkar sjukfrånvaron inom den kommunala äldrevården är olika uppfattningar om ansvaret för arbetsuppgifter, låg bemanning, graden av gemenskapen i olika arbetsgrupper och frånvarokultur.  Vi menar även att dessa organisatoriska faktorer påverkas av strukturella faktorer som ligger utanför organisationen. Ett exempel på detta är det långsamma vårdsystemet. / The purpose of this study was to analyze if the sickness absence in the public elderly care is due to organizational elements. This study is based on the research question:   What organizational elements contribute to the sickness absence in the public elderly care?   Method This thesis is based on a qualitative and a quantitative research and presumes an abductive approach. The empirical study consist a survey with 56 employees and interviews with nine employees in six departments within three units.   Results The empirical and theoretical study has contributed with the result that the sickness absence in the public elderly care is due to organizational elements. Organizational elements, which are affecting the sickness absence, are different views on responsibility of work tasks, low staffing, the degree of community in various working groups and absence culture. These organizational elements are also affected by structural elements in the external environment. An example of this is the inertial healthcare system

BACKGROUND: Powerful public-private partnerships (PPPs) can only be established if the partners are able to deal with complexity. Such partnerships may serve to stimulate local community and economic development. Thus, it may maximise the effectiveness of local groups and resources in meeting the needs for rebuilding a community through a partnership representative of the public and private sectors. A problem that exists in South Africa, is the uneven distribution of population ratios dependent on public and private sector health care service delivery, in relation to the proportion of pharmaceutical service providers in the different sectors. OBJECTIVE: The main objectives of this qualitative research investigation were to examine the prospects for PPP development in the pharmaceutical sector of South Africa as well as to explore the possibilities of a proposition for a proposed generic public-private partnership model to be managed and used in the pharmaceutical sector of South Africa. METHOD: The study comprises of the exploration of the research questions by means of a qualitative research design. The study design implicated a balance between the in-depth literature study and a qualitative research process. The researcher employed a grounded theory approach to collect and analyse the data. Data collection represented the identifiable role players and opinion formulators in the South African health care sector. By following a combination of the various qualitative sampling methods and techniques, a total of 38 (n=38) interviews were conducted. The data collected from the interviewees and from the literature study were integrated and analysed by making use of computer assisted data analysis. SETTING: The researcher selected interviewees from the South African health care sector. The interviews included role players in the pharmaceutical sector in both the public and private sectors. The interviewees further represented eight different spheres of the pharmaceutical setting in South Africa. KEY FINDINGS: The investigation identified a range of prospects for PPP development in South Africa and these were reported in terms of views, expectations and scope for success. The management elements for developing and sustaining joint ventures between the public and private sectors were identified and a proposition was formulated in theory to serve as a proposed generic PPP model (PGM) in the pharmaceutical sector for the South African health care milieu. CONCLUSION The exploratory qualitative investigation surfaced the various facets of the complexity of PPPs. The investigation concluded that several barriers, such as competition and market entry disparities between the macro and micro level pharmaceutical entities, which impede PPP development, affected the prospects for PPP development in South Africa. The South African legislation, South African Treasury guidelines, regulations and the views of the SA Competition Commission need transformation to accommodate both the micro and macro level pharmaceutical service providers in the formation of PPPs. Capacity building within the sphere of pharmaceutical service delivery to the bigger population of South Africa may become sustainable on removal of these barriers. A series of recommendations were presented and several critical issues in need of supplementary research, have been identified. / Thesis (Ph.D. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2007.

Information and Communication Technologies (ICTs) are becoming increasing relevant in policy making and governance activities. However, the broad effects of digital governance have not been adequately conceptualised; conflicting assumptions vary from rather optimistic accounts of empowered citizens to even completely dismissing the potential of engagement through technical means. This research attempts to reposition the impact of ICTs on policy making and political communities. Drawing from institutional studies, an integrated perspective is synthesised to guide case investigations in three main directions: (1) the way influences from the institutional environment are understood and balanced locally, (2) the co-evolution of institutional and technological configurations and (3) the dynamic response of institutional actors to the challenge of online engagement. The empirical part focuses on two different contexts (local government authorities and a trade union federation) that cover the holistic objective of this study. The findings inform on the extent to which ICTs are actually merging with existing governance structures. Both studies show that policy making is fundamentally different from other activities at the general intersection of Internet and politics. Citizens form online communities to organise ad hoc around single issue movements. However, this does not necessarily translate into sustainable and meaningful participation in formal politics. Hence, adapting institutional structures emerges as a complicated challenge beyond fitting technical means into existing engagement activities. On this basis, the thesis questions the extent to which policy making mechanisms are able to enact engagement from the grassroots, as for example encouraged by the social media collaboration philosophy. Implications for practice show how the alignment between new tools and the existing norms has the potential to identify paths of least resistance, and then exploit them to accomplish positives changes whose beneficial effects should not be taken for granted.

The need for government organizations to become competitive is growing with the huge instability in the economy. In parallel, Knowledge Management (KM) has been rapidly growing in the past decade as a source of influence on organisational development practices. Furthermore, the past decade research approaches largely failed to show the importance of KM initiatives in creating synergy with other initiatives to an extent that would lead towards organizational competitiveness. This study address whether KM holistically influences the different organisational development practices, specifically in the context of the government sector. To ascertain the relationships between KM and four prevalent organisational development practices identified in the literature and increasingly used in practice, a quantitative survey approach was undertaken using a series of researcher-developed scales. Based on the literature review, Organisational Excellence (OE), Organisational Learning (OL), Organisational Innovation (OI) and Organisational Competitiveness (OC) were identified to be the most repeated relations with KM. A conceptual framework was designed to test the concept of the holistic influence of KM on the four identified organisational development practices. A total of 625 valid responses were collected from top and middle management from 54 government organizations in the Kingdom of Bahrain. The model was statistically tested according to the research hypotheses by regression analysis then Structural Equation Modelling (SEM). Results reveal strong and significant correlations amongst the five prevalent organisational development practices. Even though the holistic influence of the model could not be confirmed, findings show positive KM influence on the remaining organisational development practices, thus KM is an essential factor for government organisations. Besides illustrating KM as an important source of influence, this research establishes a new direction that helps to integrate all governmental organisations initiatives in relevance to organisation development practices leading to better competitiveness. The study makes a novel contribution since it increases the probability of a holistic approach model that brings support for the decision makers to enhance the overall government organizations competitiveness. The scale developed for the model tested can be generalised and used as a self assessment tool for organisational practices in KE. This work sets a baseline for KM practices in the Government of Bahrain and similar GCC Governments and can act as a reference for researchers on KM and competitiveness in the emerging economies countries. Nevertheless, the model need to be further investigated in future research to explore the missing variables in this model to make it more fit. Therefore, the concept of holistic model needs to be further subject to empirical investigations to explore its viability. The major limitation of this research is it been addressed only in the government sector and in one country.

Since the 1980s, New Public Management (NPM) has deeply influenced the public sector across the world, and thus measuring or managing performance has become a principal element of government reform. In terms of borrowing models and techniques from the private sector, performance measurement has been significantly extended into government, but differences between the two sectors have led to difficulties and criticism of this practice with a wide inconsistent variety of different theoretical explanations about it. In this context, this thesis investigates the effectiveness of performance measurement and theoretical explanations of conditions for its success in the public sector. It focuses through a comparative methodology on Comprehensive Performance Assessment and Joint Performance Assessment that have recently been introduced between the levels of government in England and Korea for the improvement of local government performance and accountability. Extensive analysis of literature and case studies have allowed the thesis to find firstly, that the introduction of such unique assessment systems, by which the centre assesses localities, was deeply affected by the environmental commonalities of both countries such as centralisation in inter-governmental relations and enthusiasm for NPM. Second, the empirical evaluation of both tools shows that they have in practice been valid for accurate assessment, and directly functional for improvement and indirectly for accountability to the public. Their high validity and functionality proved to be mainly attributable to two characteristics. One was institutionally that both frameworks were based on a balanced approach to performance and the disclosure of assessment results to the public for facilitating competition between localities. The other was that both had impacted on internal management of local government which led to change in organisational culture with more focus on performance. However, it identified a necessity for local authorities to participate in the development process of those tools to ensure legitimacy of central management of local performance since they enjoy their own electorally based political support. The research has also found the importance of assessors’ expertise for accurate assessment and a possibility that performance measurement can contribute to the resolution of political tension and cooperation between central and local government when it focuses more on outcomes than input and process. A deeper theoretical and practical understanding of these successful experiences and important policy elements in contemporary public management contributes significantly to knowledge in the three settings of evaluation of policy instruments, comparison between countries and central-local relations. Finally, the study assists each country and others to draw lessons from each other.

The audit expectations gap is a prominent issue in the private sector. However, in the public sector, the audit expectations gap is an emerging issue that has received little attention by reseachers. To date, only a limited number of studies on the audit expectations gap in the public sector are available, either in the context of a financial audit or a performance audit. This study focused on the audit expectations gap in the context of the latter. The importance of the performance audit function in the Malaysian public sector, combined with recent developments related to this type of audit in the country (such as increasing expectations among the users and associated problems in practice) were the reasons for conducting the study in this area. Thus, the study aims to identify the existence of the audit expectations gap in the Malaysian public sector. In achieving this objective, it explores the perceptions of auditors and Public Account Committee (PAC) members, auditees and ‘other users’ (consisting of journalists, politicians and academics). The conceptual framework in this study was developed based on Chowdhury’s (1996) and Porter’s (1993) approaches. Utilising the accountability-based framework as suggested by Chowdhury, six audit concepts (auditor independence, auditor competence, audit scope, auditor ethics, audit reporting and auditing standards) were examined. Porter’s model was subsequently utilised to identify the nature and the components of the gap. This study employed two types of research methods: interviews and audit report analysis. Interviews were conducted with 37 participants comprising of auditors, PAC members, auditees and ‘other users’. The second research method involved the examination of four performance audit reports. The findings of this study indicated that the audit expectations gap exists in the Malaysian public sector in the context of performance auditing. The analysis of interviews and audit reports clearly suggest that the audit expectations gap exists over a number of auditing issues. These comprise fraud detection exercises, the influence of management, executive and other parties on auditors, outsourcing the audit to private audit firms, content and format of the audit report and extending the audit mandate to cover the question of merits of policy.

Bakgrund: I Sverige har managementfilosofin Lean Production (Lean) fått ett stort genomslag inom offentliga verksamheter. Lean, som har sitt ursprung i den japanska biltillverkningsindustrin, handlar om att öka värde för kund, effektivisera verksamheten genom atteliminera resursslöseri och arbeta med ständiga förbättringar. Migrationsverkets beslutade 2010 att införa arbetssättet Lean i hela verksamheten. På grund av eskalerande konflikter runt om i världen, speciellt i Syrien, briserade flyktingströmmarna under 2015 och människor flydde mot Europa och Sverige för att söka skydd undan krig och förödelse. Efterfrågan på Migrationsverkets tjänster ökade således enormt och myndigheten försattes i en krissituation vars storlek aldrig tidigare upplevts. Arbetet enligt Lean sattes på prov och så även myndighetens krishantering.  Syfte: Syftet med studien är att öka förståelsen av hur tillämpningen av Lean inom offentlig verksamhet påverkas i en krissituation, samt att identifiera centrala leanattribut att utveckla för krishantering. Metod: Detta är en kvalitativ fallstudie av Migrationsverket. Den bygger på fem semistrukturerade intervjuer samt dokumentstudier. Studien har en övergripande induktiv forskningsansats och utgår således från empirin.  Slutsats: Studien visar att Lean fungerade som en stödstruktur för Migrationsverket vid hanteringen av flyktingkrisen 2015. Teamarbete och mötesstruktur fick en viktig betydelse för meningsskapande för medarbetarna. Samtidigt anpassades förbättringsarbetet och processflödet till krissituationen och blev mer kortsiktigt. / Background: In Sweden, the management philosophy of Lean Production (Lean) has had amajor impact on the public sector. Lean originated from the Japanese automotive industry and involves aspects such as increasing value for customers, optimize operations by eliminating waste and continuous improvements. In 2010 the Swedish Migration Agency decided to apply Lean on the whole organisation. Because of escalating conflicts around the world, especially in Syria, the refugee stream in 2015 increased and people fled to Europe and Sweden to seek protection from war and devastation. The demand for the Migrations Agency’s services thus increased enormously and the authority found itself in a crisis which magnitude had not been experienced before. Thus, the Lean strategy as well as the crisis management of the Migrations Agency was tested. Aim: The aim of the thesis is to increase the understanding of how the application of Lean in the public sector is affected during a crisis, and to identify key aspects of Lean to develop within crisis management. Methodology: This is a qualitative case study within the Swedish Migration Agency which is built upon semi structured interviews and document studies. The thesis has an inductive approach. Conclusion: The thesis shows that Lean functioned as a supportive structure for the Swedish Migration Agency during the immigration crisis in 2015. Teamwork and meeting structure had a great importance for sensemaking among the workers. The continuous improvement and process flow was affected by the crisis situation and adjusted to the crisis situation and became short-term.

Approved for public release; distribution in unlimited. / In an environment of scarce resources and rising federal deficits the people not only expect, but demand greater accountability for the spending of public funds. This demand has created a trend in the public sector, not only in the United States, but worldwide as well, towards the importation of private sector business practices to improve accountability-oriented analysis. One example is increased emphasis on return on investment (ROI) analysis in public sector organizations. Development and application of ROI analysis is challenging in the public sector since most government organizations do not generate profit necessary for calculation of ROI in the manner in which it is done in the private sector. This thesis develops the methodology necessary for use of ROI analysis in the public sector. ROI methodology is applied for test evaluation with the Space and Naval Warfare Systems Command (SPAWAR) in San Diego. The test demonstrates that ROI can be applied successfully to assess the relative efficiency of value-added work and to improve the process of choosing between investment alternatives. Properly designed ROI analysis reveals how and for what goods and services money is spent and provides a means for comparing the value derived from investment and work performed. / Lieutenant, United States Navy

The recruitment processes include evaluation of candidates’ qualifications where the employers got the opportunity to base their recruitment decisions on personal suitability. Although the personal suitability often is used in recruitment decisions there is a lack of legal definition of what is comprised within the term personal suitability. However, there are legal regulations such as the prohibition of discrimination and demands of objective reasons in the public sector that restricts employers’ disposal of the personal suitability. This study aims to define the extent to which the concept can be used without being in conflict with the legal regulations entries that restrict the free admission for employers in the public sector. This is followed by the goal of increasing awareness by trying to identify the risks that is associated with the term and how they can be understood from a perspective of diversity in the labour market. The method used for this study is legal dogmatic with its' purpose to examine how the restrictions stands in relation to the use of the personal suitability in court cases. The result demonstrates that employers must be able to set the personal suitability in relation to the qualifications required for the requested position to prove that there is no violation with neither the prohibition of discrimination or the public requirement of objective grounds. The court cases also showed that despite the guidelines evolved through practice is still not completely uniform because each unique situation affects the legal assessment. The risks identified is that the use of personal suitability could possibly mean that discrimination becomes invisible because of possible underlying factors that will determine conclusions the employers makes to found their recruitment decision. With that realization also the problems highlighted for further studies are to in a more comprehensive study examining norms closely based on either the gender or intersectional perspective to gain a deeper understanding of how the use of the personal suitability may lead to consequences for the working populations’ opportunities in the labour market.

Syftet med föreliggande studie var att undersöka skillnader i självgenererad arbetsmotivation mellan chefer och medarbetare i privat och offentlig sektor. Resultatet baseras på 145 webbenkäter som besvarades av chefer och medarbetare i nio olika organisationer, inom de båda sektorerna. Mätinstrumentet som användes var Work Self-determination Index (W-SDI) som grundar sig i Self-Determination Theory (SDT). I resultatet framkom att chefer har högre grad av självgenererad arbetsmotivation än medarbetare, oberoende av sektorstillhörighet. Dock framkom ingen skillnad mellan privat och offentlig sektor när det gäller självgenererad arbetsmotivation. / The purpose of the study was to examine differences concerning work motivation between managers and employees in the public and private sector. The result is based on 145 web surveys answered by managers and employees in nine different organizations, within both sectors. The measuring instrument used was Work Self-determination Index (W-SDI) based on Self-Determination Theory (SDT). The result showed that managers in a higher degree have self-determined work motivation than employees, regardless of sector affiliation. However, there was no difference between private and public sector concerning self-determined work motivation.