Much current literature on management and strategy still describes strategy work as a linear, top-down, management-based, rational, logical, structured and planned change activity with clear and predictable goals. It is described as an activity in which individual managers are addressing key questions and implementing an important, management-based plan. By using the right tools and techniques, skilled managers can transform plans into reality through good leadership and systematic rollout. This way of thinking about leadership is based on an understanding of leaders as rather powerful, knowing, heroic individuals who can stand outside of their organization to plan an ideal future, and who are equipped to make employees follow their instructions in order to reach desired goals. In this thesis I research into my experiences of what is happening in an organization, taking seriously the experience of developing a new strategy. It is an organization working in the public sector in Denmark which is right now trying to find a strategy and its way through a series of 'wicked problems' not easily handled. Through the use of autobiographical narrative-based inquiry and a focus on everyday local interactions between people working together, I research into what is 'really' going on in strategy work. Drawing on the theory of complex responsive processes of relating and reflexivity, I describe and analyse the interactions in our leadership team's efforts to change the organization's strategy. In doing so themes of power, power games and power differentials, politicking and some of the paradoxes in management - such as inclusion/exclusion, local interaction and global patterning, unpredictable predictability, and conflict and cooperation - are investigated. The complex responsive process perspective views organizations as patterns of interaction and conversations between people working together. By analogy from complex adaptive systems models, sociology, psychology and philosophy, it argues that generalizable population-wide patterns emerge in unpredictable ways through exactly these local complex interaction and interplays of people's intentions, thoughts and actions. This leads me to propose generalizable new contributions to knowledge about strategy work. Examining my own experience, I problematize the 'heroic', individualistic, view of what leaders do when working with strategy, preferring to see strategy as a co-created activity that emerges in complex and paradoxical interactions between people in the organization, in the leadership team, in daily cooperation with employees, and through the interface with customers. The understanding of co-creation here being that together we co-create our social life and our social life is co-creating us, our selves, our personalities at the same time. This inseparable paradox of the individual and the group, of the one and the many is investigated. Finally, I suggest that strategy work is inseparable from the everyday messy conflictual power games of organizational life, and that leaders - through actively engaging in ongoing conversations and co-creating meaning - participate in developing new understandings of identity and culture. In talking with one another about what it is we are doing, in influencing and being influenced, and reflecting on this, we are already changing what is going on; this itself is strategy work. The narratives show that to work with strategy effectively, we need to negotiate our intentions in convincing ways through forming strong power alliances. Taking experience seriously also demonstrates a close connection between power, ethics and action, and that it is impossible to decide the 'good' thing to do before acting. Developing reflexivity, both as an individual and in collaborative work, is a prerequisite for working in an ethical way, aware of our mutual interdependence. Finally, the thesis describes some of the consequences of taking experience seriously as a strategy. It has changed the way our staff understand what they are doing, and is beginning to change the kind of assignments we take on, and how we deal with them. One spin-off has been producing two books (with more to come). We also have new and more reflexive contacts in business and knowledge-creating environments, such as universities and business schools. The thesis shows a number of results from working with strategy in this way. This indicates that the act of taking your experience seriously in itself implies a kind of transforming causality, and hereby a strategy of change.

The purpose of this thesis is to explicate and explain deficiencies in the health care system in Sweden, leading to inefficiency amongst the medical doctors. The health care system is mostly financed by the public (i.e., taxes). In order to reach conclusions we conducted a three-step empirical approach in the publicly financed health care system. The study uses a theoretical analytical lens strongly supported by previous research, which is supposed to help explain the results of the empirical studies. Study 1 consisted of semi-structured interviews. Study 2 was based on register data and examined if we could confirm that there is a correlation between administration and number of patients. Study 3 is a post-hoc analysis based on survey data from a total of 124 respondents. By using three different research methods, the study offer a more complete and holistic view of the medical doctors’ situation and the aspects of control within Swedish health care. The results confirm earlier findings in previous studies is somewhat consistent across the three separate studies (Study 1-3) that Swedish medical doctors meet very few patients. The study further identify variation among medical doctors meeting patients is very high. While some meet only one patient per day other meet up to 25 patients in a day. We could not find significant differences between doctors meeting few from those meeting many patients. Furthermore, no difference come in terms of administration between routine patient meetings or returning patients. The post-hoc analysis in part explains that management control system is poorly developed. Our result implies administrative work is not correlated to patient visits. Medical doctors themselves means that the reason to why many doctors not have a large number of patient visits is due to more administrative work. Data from patient record systems does not verify their statements. The correlation is thus opposite. The more patient visits the more administrative work. Additionally, the study implies that predetermined times modules for patient visits complicates measurements of doctors’ performances. We hope the thesis will attract attention amongst the citizens in Sweden but also amongst Swedish agencies that leads to further examinations and improvements of the publicly financed health care system. / Sverige har femte flest läkare inom EU. Ändå växer vårdköerna och det talas om läkarbrist. Är det verkligen problemet eller bottnar det i en ineffektivitet? Syftet med examensarbetet är att förklara situationen inom den offentliga svenska hälso- och sjukvården med avseende på läkarnas effektivitet och vilken roll styrningen har för prestationen. För att uppfylla syftet och besvara forskningsfrågan kommer studien att utgå från Sveriges landsting och regioner med fokus på situationen för läkarna och med tonvikt på styrningen inom landstingen. Examensarbetet använder en teoretisk analys som bygger på tidigare forskning som stöd till förståelse och förklaringar av resultaten. Examensarbetet har tre olika delstudier. I studie ett (1) genomfördes semistrukturerade djupintervjuer inom samma landsting med ett antal personer med olika befattningar för att spegla olika värdeperspektiv. I studie två (2) tog vi del av intern registerdata på en klinik för att påvisa ett eventuellt samband mellan antal fysiska patientmöten och administrativt patientarbete. Studie tre (3) var en post-hoc analys där vi diskuterar kring samband och förklaringar i utfall från studie 1 och 2. I post-hoc analysen undersöktes Sveriges samtliga landsting och regioner genom enkätundersökningen där totalt 124 läkare runtom i Sverige deltog. Resultatet visar att det är många olika faktorer som spelar in avseende läkarnas effektivitet och den situation som råder inom svensk offentlig hälso- och sjukvård idag. Bilden att svenska läkare generellt tar emot färre patienter jämfört andra europeiska länder bekräftas samtidigt som vi kan påvisa stora variationer. Ett argument som ofta framförs är att svenska doktorer arbetar med patienten administrativt och att detta arbete inte återspeglas när man mäter antal fysiska möten. Genom journalstudier kan vi inte bekräfta detta samband. Våra resultat visar att rent administrativt patientarbete korrelerar till antal fysiska möten mellan läkare och patient. Vi ser också att styrning genom exempelvis förutbestämda tidsmoduler gör att prestationer verkar bli svårare att följa upp. Vår förhoppning med examensarbetet är att väcka ett större intresse hos allmänheten och myndigheter för dessa frågor vilka kan leda till granskning och förbättring av den offentliga svenska sjukvården.

Over the last two decades the impact of power in communicative planning has gained prominence in discussions about meaningful planning, i.e. planning that achieves the goals as set out in the plan and also has wider socially desirable environmental, social and economic outcomes. This study aims to examine the influence of power on communication in the compilation of municipal Integrated Development Planning in South Africa, specifically as it affects intra- and intergovernmental relations in the IDP preparation process in local municipalities. This dissertation is the result of a historical study into the 2000/2001 and 2001/2002 Integrated Development Plan process in the local governments of Kungwini Local Municipality, and Klerksdorp Local Municipality as study areas. The time lapse between the events that took place in these municipalities and the completion of this study assists in providing a more objective view of the power relations at play. Throughout the study emphasis is placed on certain concepts that influence the outcome of planning processes and the planning processes itself, as summarised in the final chapter. They are: <ul> <li> The quality of inter- and intra-governmental relationships;</li> <li> The awareness and use of power in planning;</li> <li> The concept and nature of “meaningful communication”; and</li> <li> The role and impact of power on such communication.</li> </ul> As an exploratory historical study into the power interface in IDP, it provides an interesting perspective on the dynamics of compiling an IDP and opens up the opportunity for more such studies in other local governments in South Africa with the influence of power on communication in intergovernmental planning processes (specifically IDP in local municipalities) and general studies regarding the effect of power in communicative planning as focus. This study also provides an indication of the pressures planners face in the pursuit of meaningful/useful planning results. / Dissertation (MT&RP)--University of Pretoria, 2009. / Town and Regional Planning / unrestricted

La Réussite éducative est un dispositif mis en place en 2005 visant à aider les enfants en « fragilité » de deux à seize ans scolarisés ou domiciliés dans les territoires en Politique de la Ville. Loin d’être seulement un dispositif d’aide éducative, la Réussite éducative est aussi un instrument de réforme. Cette thèse répond à deux questions : comment un dispositif extérieur à l’Éducation nationale réforme la politique éducative et quelles sont les implications de la réforme portée par la Réussite éducative.Nous mobilisons dans un premier temps la sociologie des instruments de l’action publique et nous présentons notamment les ambiguïtés de la Réussite éducative, son déploiement et sa carrière. Il s’agit alors de comprendre comment ce dispositif est devenu à la fois un instrument éducatif et un instrument de réforme, comme celui-ci s’implante localement, et comment il évolue selon les différents contextes.La Réussite éducative porte une recomposition de la politique éducative accordant une place accrue aux associations et aux collectivités territoriales. Cette recomposition implique des changements dans les modalités d’emploi et de travail dans la politique éducative que nous étudions en mobilisant les analyses sur les processus d’invisibilisation du travail.Au carrefour d’une sociologie de l’action publique et de ses instruments, du travail et du monde associatif, cette thèse aspire à être une contribution à l’analyse de la Nouvelle Gestion Publique dans le secteur éducatif. / "Educational Success" is a political device that was set up in 2005. It aims at helping children between two and sixteen years who are labelled as "weak" in the local territories where urban policies are set up. Far from being only a help to the children’s education, it is also a tool of reform. This thesis answers two questions: how does a device that is external to the national system of education reform the politics of education, and what are the implications of the reform it implements. Through a sociology of the instruments of public action, we will present the ambiguities of "Educational Success", its expansion, and its career. We will explain how this tool of reform was established locally and how it evolved according to various elements of context. Educational Success reconfigures educational policies through an approach based on local authorities and associative organisations. This implies changes in the terms of employment of its actors and, namely, a process of making their work "invisible". At the crossroad between public action sociology, sociology of work and sociology of associations, this thesis contributes to the analysis of the New Public Management in the educative field.

The public sector is today based on the reform, New Public Management, which was created to increase quality. The reform has forced the possibility of measurability in the public occupation. Measurability has also created marketing competition, which has also resulted in the emergence of privatization in the public sector. This market competition has resulted in a change in the professional role of preschool teachers that has become more market oriented. The operations work is aimed at a customer satisfaction oriented purpose. The purpose of this study was to investigate whether New Public Management hasaffected the employment situation in both municipal and independent preschool activities. The study was conducted with the help of semi-structured interviews. The conclusion of this study is that deprofessionalization in the profession has not been experienced, one experiences a commonality indecision-making about goals. The administrative part is of great importance for the activities and the children; however, the staff is affected by lack of time to be able to complete the administration. In addition to this, a lack of staff is a negativity for achieving a good working environment for bothchildren and staff. The study also shows a desire for a more suitable balance between resources andwork activities. / Den offentliga sektorn finner sig idag inom reformen, New Public Management, som skapats för att öka kvalitet. Reformen har framtvingat mätbarhet hos de offentliga verksamheterna. Mätbarheten har vidareskapat en marknadskonkurrens, vilket också resulterat i uppkomsten utav privatisering inom de offentliga verksamheterna. Denna marknadskonkurrens har omvandlat förskolelärarnas yrkesroll till ett allt mer marknadsfokuserat yrke. Där ändamålet för verksamheterna styrs av kundnöjdhet. Syftet med denna studie var att undersöka huruvida New Public Management har påverkat arbetssituationen i både kommunala- och fristående förskoleverksamheter. Studien har genomförts med hjälp utav semistrukturerade intervjuer. Slutsatsen av denna studie är att en deprofessionalitet i yrket inte har upplevts, man upplever en gemensamhet i beslutsfattning om mål. Den administrativa delen anses varaav stor vikt för verksamheterna och barnen, däremot påverkas personalen av tidsbrist för att kunna fullfölja administrationen. Utöver detta utgör brist på personal en negativitet för att uppnå en bra arbetsmiljö för både barn och personal. I studien framgår vidare en önskan om en mer lämplig balans mellan resurser och arbetssysslor.

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Statistik från Socialstyrelsen (2019) visar att en stor mängd av den äldre befolkningen besväras av sin ensamhet i dagens Sverige. Äldre personer som bor på äldreboenden tycks besväras i större utsträckning av ensamhet. Folkhälsomyndigheten (2019) menar att det finns tydliga kopplingar mellan ensamhet och psykisk ohälsa och där depression bland äldre är så pass vanlig att det idag klassas som ett folkhälsoproblem i Sverige.  Regeringskansliet (2018) skriver i sin handlingsplan utifrån Agenda 2030 att de ska arbeta förebyggande för att minska den psykiska ohälsan tillsammans med Sveriges Kommuner och Landsting. Därför fokuserar den här studien på hur enhetschefer inom kommunala äldreboenden arbetar förebyggande genom att minska den ensamheten som bidrar till psykisk ohälsa bland äldre. Studiens syfte var att genom forskningsintervjuer undersöka hur enhetschefernas förebyggande arbete för att minska äldres ensamhet på kommunala äldreboenden kan influeras av enhetschefens syn på ensamhet bland äldre och den organisatoriska strukturen. I undersökningen användes socialkonstruktivismen som teori för att analysera enhetschefernas konstruktion av ensamhet bland äldre. New Public Management, individualisering, destabilisering samt medmänsklighet och empati är andra teorier som användes för att se analysera hur organisatoriska förutsättningar kunde influera det förebyggande arbetet för att minska äldres ensamhet. I undersökningen intervjuades fem enhetschefer och resultatet visade att det inte finns någon nationell överenskommelse för hur enhetschefer ska driva ett förebyggande arbete för att minska ensamheten bland äldre. Det finns ingen gemensam överenskommelse för vad ensamhet är och därför konstrueras äldres ensamhet olika beroende på individuellt intresse vilket leder till olika möjligheter för de boende. Även enhetschefernas specifika arbetsuppgifter som sker i uppdrag från kommunpolitiker, deras närvaro i verksamheten och andra aktörer påverkade konstruktionen av ensamhet som influerar det förebyggande arbetet för att minska ensamhet bland äldre.

Profound changes in higher education induced by the reforms of the New Public Management (NPM) have led to administrative growth, professionalism, managerialism, and higher relevance of the economic principle. As a further consequence, the importance of the organizational perspective has increased. Thus, questions about effective organizational structures and their design frameworks have become more crucial. The contingency approach provides insights into these questions because it investigates the effectiveness of organizational structures in different situations. Based on expert interviews with faculty managers and subsequent qualitative content analysis, in-depth insights are gained regarding criteria of effectiveness of German faculties, dimensions of their organizational structure, and their contextual factors from their subjective perception. Furthermore, it is possible to renew the approach, to refute criticism, and to build a reference framework as a precursor for developing new theories.

Syftet med studien har varit att med fokus på organisationsförändringar undersöka vilka bakomliggande orsaker som ligger till grund för hur en Region i Sverige arbetar med införandet av egna slutenvårdsplatser inom abstinensvård, utifrån de nationella målen för god vård och hur införandet av sådana vårdplatser kan komma att påverka vården. Genom att analysera Regionens egen utredningsrapport tillsammans med den revisionsrapport som externa konsulter skapat på uppdrag av Regionen, har denna kvalitativa fallstudie bidragit till en övergripande bild av bakomliggande orsaker som ligger till grund för beslutet. För att ge en fördjupad förståelse för dessa bakomliggande orsaker har studien kompletterats med en intervju där områdeschefen för Regionens beroendevård har bidragit med sin kunskap inom området. Resultatet tyder på att upphandlad abstinensvård kan försvåra säkerställandet av vårdens kvalitet, då det är problematiskt för den offentliga sektorn att kontrollera och utvärdera vård som tillhandahålls av privata vårdgivare. / The aim of the study has been to focus on organizational changes to examine the underlying causes of the Regions decision to implement a new unit for withdrawl treatment, based on the national goals for good health care and how the implementation of such new unit can affect provided care. By analyzing the Regions own enquiry report along with a review report made by external consultants on behalf of the Region, this qualitative study has compiled a general comprehension of underlying causes that the decision to open a new unit is based upon. For a deeper understanding of the underlying causes a supplementary interview took place with the area manager of the withdrawl treatment in this Region, who added knowledge to the study. The result indicates that outsourced health care can lead to difficulties in ensuring the quality of good care, because it is problematic for the public sector to control and evaluate care provided by private care givers.

This thesis evaluates the effects of the Swedish ordningsvakt system with regards to its contribution to public safety. Building on a body of critical research regarding the effects of outsourcing of public services and police forces in particular, it develops an insight into the driving factors and underlying causes of the expanding use of ordningsvakter. The effects of ordningsvakt use in 17 Swedish municipalities on violent crime, theft, and vandal-ism have been measured through a multivariate regression model. Over multiple specifications, it became apparent that a statistically significant effect can be observed for vandalism but not other types of crime.The thesis finds that ordningsvakter in public spaces provide at most a very modest contribution to public order and fail to achieve the core objective of reducing violent altercations. This may be either due to a general inade-quacy of the system, or due to displacement effects caused by the deployment of guards. The resulting policy recommendation is an exploration of alternative ways to enable public order and safety measures on the municipal level, particularly a reintroduction of municipal police forces.