Drawing from collaborative public management, this article seeks to contribute to public service logic by focusing on what precedes the public service user's realization of value: the value proposition. A new care model for elderly people with multiple chronic diseases shows that coordinators with an inter-organizational mission, vertical and horizontal supporting structures, trust established through relationships, and recognition of service systems' embeddedness in social systems are pivotal for the ability of public service organizations to develop coordinated value propositions. The contribution to policy and practice is an increased understanding of a coherent, rather than fragmented, welfare system for users/citizens.
Purpose The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work. Design/methodology/approach Qualitative case study based on interviews ( n=27) and observations ( n=10). Findings The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute. Practical implications Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed. Originality/value Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.
PurposeThe purpose of this paper is to inductively explore the context-specific preconditions for nurses' perceived organizational support (POS) in healthcare organizations.Design/methodology/approachA qualitative interview study was performed, based on the critical incident technique (CIT), with 24 registered nurses in different specialities of hospital care.FindingsThe nurses perceived three actors as essential for their POS: the first-line manager, the overarching organization and their college. The preconditions affecting the nurses’ perceptions of organizational support were supportive structuring and structures at work, as well as individual recognition and professional acknowledgement.Originality/valuePrevious studies of POS have mostly had a quantitative outset. In this paper, context-specific preconditions for nurses' POS are described in depth, enabled by the qualitative approach of the study. The findings may be used to guide healthcare organizations and managers aiming to foster nurses' POS, and thereby, benefit nurses' well-being and retention, as well as healthcare quality and efficiency.
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