BackgroundComparisons of health system performance, including the regulations of interprofessional relations and the skill mix between health professions are challenging. National strategies for regulating interprofessional relations vary widely across European health care systems. Unambiguously defined and generally accepted performance indicators have to remain generic, with limited power for recognizing the organizational structures regulating interprofessional relations in different health systems. A coherent framework for in-depth comparisons of different models for organizing interprofessional relations and the skill mix between professional groups is currently not available. This study aims to develop an ideal-typical framework for categorizing skill mix and interprofessional relations in health care, and to assess the potential impact for different ideal types on care coordination and integrated service delivery.MethodsA document analysis of the Health Systems in Transition (HiT) reports published by the European Observatory on Health Systems and Policies was conducted. The HiT reports to 31 European health systems were analyzed using a qualitative content analysis and a process of meaning condensation.ResultsThe educational tracks available to nurses have an impact on the professional autonomy for nurses, the hierarchy between professional groups, the emphasis given to negotiating skill mix, interdisciplinary teamwork and the extent of cooperation across the health and social service interface. Based on the results of the document analysis, three ideal types for regulating interprofessional relations and skill mix in health care are delimited. For each ideal type, outcomes on service coordination and holistic service delivery are described.ConclusionsComparisons of interprofessional relations are necessary for proactive health human resource policies. The proposed ideal-typical framework provides the means for in-depth comparisons of interprofessional relations in the health care workforce beyond of what is possible with directly comparable, but generic performance indicators.

The aim of this article is to assess the contribution provided by the instrumental theory of translation when conceptualizing micro processes of change. A core assumption of this framework is that the translation of management ideas is characterized by regularities, or translation rules, and that performance of translation rules depends on translation competence. The assessment is based on an exploration of how the process of providing contents to a new model of manpower planning among doctors in a Norwegian health trust unfolded. Participant observation and documents represent the main sources of data. The analysis demonstrates that project methodology competence emerges as a key factor of influence on the performance of translation rules, leading to the interpretation that there is a 'taken-for-grantedness' in change implementation which suggests additional competences at play. We propose that the instrumental theory of translation would benefit from extending the framework for contextualizing the performance of translation rules. MAD statement Empirical insights from this article relate to the increasing number of change agents that are assigned the task of translating management ideas into organizations. Traditionally, research on change management does not combine a focus on the translation of ideas and the design of change processes. Empirical data from this study, however, demonstrate that change design competences are part of a 'taken-for-grantedness' in change implementation, which might impact how new management ideas are being translated. We suggest that change agents will benefit from both raising the awareness of conducting translations, and of the impact of change design when translating management ideas.

A promising way to stimulate industrial energy efficiency is via energy management (EnM) practices. There is, however, limited knowledge on the implementation process of EnM in manufacturing firms. Aiming to fill this research gap, this study explores the implementation of a corporate environmental program in an incumbent firm and the ensuing emergence of EnM practices. Translation theory and the ‘travel of management ideas’ is used as a theoretical lens in this case study when analysing the process over a period of 10 years. Furthermore, based on a review and synthesis of prior studies, a ‘best EnM practice’ is developed and used as a baseline when assessing the EnM practices of the case firm. Building on this premise, we highlight four main findings: the pattern of translation dynamics, the key role of the energy manager during the implementation process, the abstraction level of the environmental program and, ‘translation competence’ as a new EnM practice. Managerial and policy implications, as well as avenues for further research, are provided based on these results.

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