Umeå University's logo

The World Health Organization (WHO) is a global organization that nowadays has integrated gender issues into its policy, programmes and budget. How then is the state of affairs in the area of gender equity at the ultimate governing bodies of the modern WHO? This study aims to assess the representation of women and men and their promotion within the supreme decision-making bodies of the WHO during the year 2000. Information sources used are the official and confirmed protocols of the 53rd World Health Assembly (WHA) in 2000 and of the two Executive Board (EB) meetings of the corresponding year. A descriptive quantitative content analysis approach is used exclusively. The present study demonstrates strikingly skewed gender distribution, with men substantially at an advantage numerically in the prominent positions at the WHA 2000. Additionally, men also hold an advantage in terms of being promoted to leading positions within the bodies examined, notably all upgraded chairs of the EB during 2000. However, the formerly male-dominated supervisory positions of the WHO are, these days, challenged by women having been elected at the very top of the WHO. The present study stresses the need to elaborate a qualitative research design to advance the understanding of the social construction of gender in supreme governing positions of the modern WHO.

Purpose: The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development.

Design/methodology/approach: A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years.

Findings: The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found.

Practical implications: A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization’s measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks.

Originality/value: Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor’s view on important factors to consider when building a coherent organizational M & F strategy.

Purpose – This paper investigates the prospects and difficulties of multi-professional teamwork in humanservices from a professional identity perspective. The purpose of this paper is to explore the mutual interplaybetween professional identity formation and team activities.

Design/methodology/approach – This is a process study of two cases of multi-professional teamwork infamily care. Data were collected through in-depth interviews with team members and managers. The analysisfollows a stepwise approach alternating between the individual and team levels.

Findings – In showing the mutual interplay between teamwork processes and individual identity formation,the study contributes knowledge on professional identity formation of mature professionals; in particularshowing how unique individual identification processes have different consequences for multi-professionalteam activities. Further, alternative shapes of interplay between individual identity formation and team-levelprocesses are identified.

Research limitations/implications – Despite the fact that the sample is small and that collaborationintensity was relatively low, the paper succeeds in conceptualising the links between professional identityformation and multi-professional teamwork.

Practical implications – In managing multi-professional teams, team composition and the team’s earlydevelopments seem determining for whether the team will reach its collaborative intentions.

Originality/value – This paper is original in its exploration of the ongoing interplay between individualidentity formation and multi-professional team endeavours. Further, the paper contributes knowledge onmature professionals’ identity formation, particularly concerning individual variation within and betweenprofessional groups.

Purpose: While previous research acknowledges the influence of roles on routine dynamics, roles are largely taken for granted. The purpose of this paper aims at examining how roles and routines interplay in accomplishing work in organizations.

Design/methodology/approach: A four-year ethnography of an emergency department (ED) at a university hospital was conducted through observations, interviews and documents.

Findings: Roles and routines are formed by scripted and unscripted patterns, which are brought into performances following a situational assessment. Performances trigger patterning processes prompting the co-construction of role and routine patterns.

Practical implications: This study highlights the importance of designing flexible structures. Managers can benefit from identifying unscripted patterns critical to work performance and making them part of scripted patterns. Managers should contemplate the influence that individuals, their relations and context have on how work is done.

Social implications: This study suggests that the existence of different patterns impacts the length of wait times in EDs, a societal issue worldwide because of the effects that waiting can have on the patient's health condition and the unnecessary costs it carries. This study can help design solutions to decrease wait times.

Originality/value: This paper contributes to research on routine dynamics by providing a more nuanced explanation of the sources of endogenous change and how these enable organizational stability and flexibility.

PURPOSE: Information is scarce on healthcare managers' understanding of simulation educators' impact on clinical work. Therefore, the aim of this study was to explore healthcare managers' perceptions of the significance of clinically active simulation educators for the organisation.

DESIGN/METHODOLOGY/APPROACH: Healthcare managers were invited to be interviewed in a semi-structured manner. Inductive thematic analysis was used to identify and analyse patterns of notions describing the managers' perceptions of simulation educators' impact as co-workers on their healthcare organisations.

FINDINGS: The identified relevant themes for the healthcare unit were: (1) value for the manager, (2) value for the community and (3) boundaries. Simulation educators were perceived to be valuable gatekeepers of evidence-based knowledge and partners in leadership for educational issues. Their most prominent value for the community was establishing a reflective climate, facilitating open communication and thereby improving the efficacy of teamwork. Local tradition, economy, logistics and staffing of the unit during simulation training were suggested to have possible negative impacts on simulation educators' work.

PRACTICAL IMPLICATIONS: The findings might have implications for the implementation and support of simulation training programs.

SOCIAL IMPLICATIONS: Healthcare managers appreciated both the personal value of simulation educators and the effect of their work for their own unit. Local values were prioritised versus global. Simulation training was valued as an educational tool for continual professional development, although during the interviews, the managers did not indicate the importance of employment of pedagogically competent and experienced staff.

ORIGINALITY/VALUE: The study provided new insights about how simulation educators as team members affect clinical practice.