Building sustainable hospitals: A resource interaction perspective

In response to a growing influence of patients, higher specialisation, technological advancement and the need to provide care services more efficiently, the issue of sustainability in healthcare has gained prominence. The purpose of this paper is to investigate how the social and economic sustainability of healthcare are dependent on interconnecting resources across organisational borders and in different settings over time. Adopting a product development process perspective, the paper explores the gap between a planned healthcare facility and how it actually came to be used, through a longitudinal case study of the Skandion clinic, a small, highly specialised, hospital in Sweden. The findings suggests that integration of healthcare resources over time is central to achieve social and economic sustainability goals. The results hereby contend the prevailing view of hospitals as independent organisational units and highlights the need for more holistic analyses of sustainability in healthcare. Analyses which take into account the complex interdependencies stretching across networks of interconnected facilities and organisational units

Evidence-based urology in practice : heterogeneity in a systematic review meta-analysis

The definitive version is available at www3.interscience.wiley.com.Peer reviewedPreprin

When construction projects are to satisfy health care needs - partnering as a way of connecting the two?

In the construction industry the intention with partnering is that it should facilitate closer interaction between the client and the project organisation and particularly assist the contractor-client communication. In the Scandinavian countries, a number of high-technology hospitals are currently being planned for and being built through partnering agreements with intentions of providing modern health care supported by advanced medical technology. Health care represents a complex structure of actors, resources and activities that are to be coordinated toward the purpose of providing relevant and consistent care services to individuals over time. The remaining project organisation embodies construction-related organisations that represent a temporarily organised constellation of actors, resources and activities in the design, production and delivery of the building. Thus, as construction “meets” health care in a construction project, there are very different requirements that are to be fulfilled; that of gaining benefits from temporarily organising around a construction project and that of having a facility that supports complex care processes over time. The differences in requirements in turn rests on the different logics of on the one hand temporary and on the other hand permanent organisations of a different set of activities, resources and actors. Through the industrial network approach (INA) we outline the interactions taking place between key actors in a large health care construction project practicing partnering in Sweden, and investigate how partnering affects the communication of these different logics in play. How is the interaction coloured by these different requirements and logics during the different project phases, and what is the role of partnering in creating a favourable setting for useful interaction

"Chorus of the Saved" : Constructing the Holocaust Survivor in Swedish Public Discourse, 1943-1966

In this dissertation I examine how the Holocaust survivor has been constructed in Swedish public discourse during the 1940s, 1950s and 1960s. This is done using a Foucauldian-inspired genealogical method through which an eclectic collection of sources—newsreels, films, radio programs, television programs and newspaper articles—is analyzed. The theoretical underpinnings of this analysis are based on Ian Hacking’s concept of discourse where the classification of survivor ‘types’ has a direct bearing on the expressions possible for those who are classified, i.e. individuals with Holocaust experience. The overarching research question of the dissertation therefore asks: how did a Holocaust survivor ‘type’ develop in Sweden during the 1940s, 50s and 60s?  The main thrust of the argument presented in the dissertation is that the concepts of ‘silence’ and ‘excess’ have always disciplined the ways in which Holocaust survivors have been conceived of as both victims and witnesses in Swedish public discourse. The communication of Jewish suffering by survivor-witnesses has both been framed as a dangerous, destructive force which could instigate unnecessary conflict while it, at the same time, has been positioned as a remedy to collective forgetfulness as well as a solution to rising levels of xenophobia and antisemitism. How survivors have been constructed historically also demonstrates the flawed logic of a historical progressivism within which Holocaust memory is seen to steadily go from silence to interest/increased knowledge. What the research presented in this dissertation shows is that this process is not determined by historical progression but by the underlying problematization of Holocaust survivors’ utility.  

Drivers and Hindrances to Med-Tech Innovation : A device's guide to the Swedish healthcare galaxy

Today, the expectations on new medical technology solutions are substantial. On the one hand, healthcare policy expects new technologies both to improve the quality of people’s life and to reduce the burgeoning healthcare costs. On the other hand, innovation policy expects new med-tech solutions to stimulate economic growth, with large emphasis on the production of new solutions. However, despite the growing importance of med-tech innovations it is cumbersome to embed these innovative promising products into use in the Swedish healthcare sector. This thesis investigates med-tech innovation by following a microwave-based device in the treatment of the common disease BPH, Benign Prostatic Enlargement. This is an empirically based longitudinal study where the microwave device is used as a probe to capture a med-tech innovation journey. We follow the device through the efforts of technological and scientific development, through complex industrial production structures and foremost inits struggles to achieve widespread use in Swedish public healthcare. This study identifies a number of hindrances and drivers and, importantly, how they are interconnected in the innovation process. By applying the different settings of development, production and use of this device, a central finding is that the very same mechanisms can have contradicting effects in the different settings. Moreover, what functions as a trigger to innovation during development, can become later a hindrance to use. The study also shows that, whereas drivers prevail over hindrances in the development and production of med-tech solutions, hindrances clearly prevail in their use, which involves the provision of healthcare services. Not only has the use setting a generally weak financial support, but its organisational structures and regulations do also have a negative impact on the spread of new solutions in healthcare.

Applying the resource interaction approach to policy analysis - Insights from the antibiotic resistance challenge

This paper explores how the Resource Interaction Approach (RIA), namely the 4Rs model and the three settings of developing-producing-using, can be applied to complex policy analyses. We use the global sustainability challenge of antibiotic resistance as an example to define an agenda about how these analytical tools can frame and analyze such problems systematically. We find that these tools offer benefits to policymakers, including flexibility in framing problems, by selecting the focal resources and values to be prioritized, and the ability to visualize the direct and indirect interdependencies that enable or hinder value creation. Moreover, the RIA can point at the resource interfaces that need to change through specific policy interventions, as well as the potential network-level barriers to such changes. We also find that the RIA needs to be complemented by network-level analyses of deal structures and monetary flows in order to better capture the legal and financial dimensions of policy problems and solutions

Crisis Documentation and Oral History : Problematizing Collecting and Preserving Practices in a Digital World

Collecting in times of crisis is a precarious task. In recent years, oral historians have considered the risks and pitfalls that so called crisis or rapid response collecting entail. However, in countries where oral history practices are not dominant within the cultural heritage sector, these discussions surrounding ethics and collecting have had little impact. In this article we problematize the absence of oral history perspectives on the ethics of crisis collecting through a Swedish case study involving the daily newspaper Dagens Nyheter (DN) and Sweden's most prominent cultural heritage institution, Nordiska Museet (the Nordic Museum). In 2015, DN started interviewing refugees for a social media-based project entitled RefugeeSweden. Excerpts from the interviews as well as photographs of the refugees were published on Instagram and Twitter, with Nordiska Museet later acquiring this material. Through this case study we show how the act of digitization constitutes a process of transformation which fundamentally affects collections and how they can be understood. In addition, we demonstrate how seemingly inclusive notions of digitization and representation can obscure exclusionary practices of institutions that have not considered cocreation or participatory practices.DigiCONFLICT. Digital Heritage in Cultural Conflict

Digitization, Vulnerability, and Holocaust Collections

Although digitization has become a word that is almostsynonymous with democratization and citizen participation, manymuseums and other cultural heritage institutions have found it difficult to live up to this political vision of inclusivity and access for all.In Sweden, political ambitions to digitize the cultural heritage sectorare high. Yet, institutions still struggle to reconcile their previouspractices with new technologies and ethical guidelines for collecting and curating material. In this article we identify, analyse, andtry to find resolutions for the current gap that exists between cultural heritage practice and government policy on digitization, openaccess, and research ethics. By examining two Swedish examplesof Holocaust collections that have not been digitized because of internal policies of secrecy and confidentiality, we attempt to demonstrate how discourses about vulnerability affect the ways in whichcertain archival practices resist policies of accessibility and ethicalresearch. In order to unpack the discourses on vulnerability, Carol Bacchi’s post-structural approach to policy analysis has been usedtogether with Judith Butler’s theories on vulnerability and resistance. In addition to understanding how cultural heritage institutionsin Sweden have protected some of their collections and how thishas obstructed efforts to make these collections more accessible,we  also offer some suggestions on how these issues can be resolved by reimagining digitization as transformation.DigiCONFLIC