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The purpose of this study is to present a comprehensive approach to studying organizational culture using “soft measures” to facilitate sustainable quality development in organizations. The purpose is also to present, discuss and compare the results from a survey designed to measure a company’s value base.

A number of different methods were used to collect soft data to study and measure organizational culture and at the same time influence the culture and the leadership within three organizations. One method, the survey, was used on two different occasions to obtain an overview of the culture within an organization and to investigate if the activities had influenced the culture and the leadership.

The application of soft measures used by leaders to study and develop organizational culture resulted in statistically significant positive changes in organizational work culture, according to a pre-post survey after a short period of one year.

The approach can be used by leaders in different types of organizations as the challenge of changing the organizational culture through the leadership seems to be a common challenge regardless of line of business.

The study shows the benefits of using a comprehensive approach to assess an organization’s culture based on qualitative measures and analysis.

The purpose of this paper was to modify an existing survey that measures co-worker perceptions of health-related quality management (QM) values and perceived health and to measure both co-worker and manager perceptions of those values. The purpose was also to test the modified survey and then compare the results from managers and co-workers from two organizations in which the survey has been used to measure baseline data in a lean research project and to help managers understand the areas where improvement is needed.

An earlier survey measuring co-worker perception of the dimensions of the health-related QM values “leadership commitment” and “participation of everybody” has been developed with corresponding statements for managers. The results of the survey were analyzed using SPSS (Statistical Package for the Social Sciences), the Cronbach’s alpha coefficient was calculated for each of the dimensions, and the correlations between the dimensions and the health index were investigated using the Pearson correlation. The mean and standard deviation were also calculated.

The modified survey is presented in the paper, and the results demonstrate that the managers’ perception of the presence of health-related QM values is higher than that of the co-workers. Seeing the leadership from the co-workers’ standpoint compared with the managers’ perspective provides novel insight for both the researcher and the managers.

Leaders in organizations must develop greater efficiency to improve operational performance and develop healthy work environments. Practicing QM can benefit performance and is central for inspiring quality and efficiency within organizations, as well as for enhancing co-worker well-being. Earlier research found relationships between co-workers’ perception of their health and the health-related QM values “leadership commitment” and “participation of everybody.” With the survey presented in this paper, it is possible to measure these health-related QM values and provide a comparison between manager and co-worker perceptions.

The purpose of this paper is to investigate the effects a lean initiative has on the health-related quality management (QM) values, “Leadership Commitment” and “Participation of Everybody,” as well as on perceived co-worker health in the public sector.

A case study was carried out at a municipal division that had been working with lean for approximately 18 months. A questionnaire was used to measure the effect on health-related QM values both before and after the initial 18 month period. Documents from the intended lean implementation were studied at the starting point and after 18 months; this was followed up by examining new documents. The results from the questionnaires were analyzed using SPSS and the documents were analyzed by means of document comparisons and consensus discussion in the research group.

The effects on the health-related QM values; “Leadership Commitment” and “Participation of everybody” in this study showed that the values still permeated the organization to a relatively high extent after 18 months but that no statistical differences can be shown between the two measurement points. When measuring what effects a lean initiative has on values, a period of 18 months might be too short, if significance changes are expected. None the less, the results can be a way of monitoring the development of these softer values. Something that is equally important is to see if there have been any major changes, as a way of keeping the work with building a new culture alive and in focus. The results strengthen the assumption that a long-term mindset is needed when QM initiatives such as lean are applied within an organization especially when changes to values and workplaces are expected.

This study has further explored the QM in relation to lean in the respect of how the QM values “Leadership commitment” and “Participation of Everybody” are effected by a lean initiative.

Team collaboration is essential to ensure the quality of care and patient safety when critically ill patients are transferred from an intensive care unit (ICU) to a general ward. Measuring team collaboration in the patient transfer process can help gain insights into how team collaboration is perceived and how it can be improved. The purpose of this paper is to describe the development and testing of a questionnaire aiming to measure perceived team collaboration in the patient transfer process from ICU to the general ward. This study also aims to analyze the results to see how the survey could help improve team collaboration within ICU transitional care.

Statements, factors and main areas intended to measure perceived team collaboration were developed from a theory. The questionnaire was tested in two ICUs at two hospitals located in Sweden, and the results were analyzed statistically.

The results showed that the questionnaire could be used for measuring perceived team collaboration in this process. The results from the survey gave insights that can be useful when improving team collaboration in ICU transitional care.

The collaboration between two research subjects, Nursing Science and Quality Management, has given new perspectives in how cultural and systemic differences and opportunities can help improving team collaboration in ICU transitional care, by shifting focus from the individual to team, culture, system, process and continuous improvement.

The developed questionnaire can be used to measure perceived team collaboration and to identify areas for improving team collaboration in the ICU transitional care process.

There is a sparse amount of research about measuring team collaboration in ICU transitional care, and this study contributes to filling this research gap.

This paper aims to explore how leaders can develop value-based leadership for sustainable quality development in Lean manufacturing.

A qualitative meta-analysis was conducted using data from a three-year study of Lean manufacturing in Sweden using the Shingo business excellence model as an analytical framework.

This study demonstrates that leaders can develop value-based leadership to support Lean manufacturing by defining and articulating the organization’s values and accompanying behaviors that are needed to support the strategic direction; creating forums and time for leaders to identify the why behind decisions and reflect on their experiences to be able to lead a transformative process; and using storytelling to create a coaching culture to connect values and behaviors, to the processes and systems of work.

This paper contributes insights for developing value-based leadership to support a systemic approach to sustainable quality development in lean manufacturing. Findings are based on a limited case sample size of three manufacturing companies in Sweden.

The findings were derived using a unique methodological approach combining storytelling, appreciative inquiry and coaching with traditional data collection methods including surveys and interviews to identify, define and shape value-based leadership in Lean manufacturing.

The purpose of this paper is to present findings from a study of value-based leadership in which design thinking was used as a participatory, iterative process to examine and stimulate changes in organizational culture and develop value-based leadership in Swedish manufacturing. Of particular interest to the authors was to make visible and understand the constraints in leadership that kept leaders from understanding and working with organizational culture and values.

A three-year multi-site case study was conducted in collaboration with three manufacturing companies in Sweden. The study design was based on a collaborative, iterative model using the Stanford Design thinking framework in which data were collected through a series of workshops using a variety of sources including: leadership survey; interviews with three general directors; focus groups with middle- and top-level managers; observations and cultural analysis, survey; storytelling and appreciative inquiry (AI); and an employee questionnaire. Respondents in the study represented leadership teams in three Swedish manufacturing companies and their employees.

In general, there is a lack of dialogue among leaders about what is leadership, what is culture and what is meant by values in the organization. As well, there is a heavy emphasis on structure and process, yet, at the same time, there lacks a clear understanding about why the structures exist and how they can be used to spawn innovation. Moreover, participating leaders in manufacturing succumb to a crisis leadership model that results from the heavy emphasis on productivity and bottom-line effectiveness. Design thinking and the methods used to develop work culture, including AI, storytelling and coaching, provided leaders with new insights into the culture within the company. Leaders were able to identify both constraints and possibilities for changing the culture from disengagement to engagement. Through the process, they also began to identify values and recognized the importance of valuing employees to affect innovation and build a culture of engagement. The authors also witnessed increased dialogue among leaders that reflected an understanding of the importance to engage middle managers and employees in problem solving and innovation.

This study demonstrates that leaders can benefit from innovative approaches to identifying and building work culture to achieve value-based leadership.

The purpose of this paper is to explore existing and desired methodologies for systematic quality work to promote quality in preschools from the principal’s perspective.

A collaborative approach was used in this research project, and principals were asked to complete portfolio assignments. Their answers to those portfolio assignments were analysed by the research team and subsequently compared to total quality management values.

Existing and desired methodologies for systematic quality work are presented and sorted into 13 and 17 groups, respectively. The principals desire four times more methodologies than they are presently using to promote systematic quality work, and the results show that they must extend their methodologies to support TQM values.

This research is based on answers collected from 18 principals in one municipality in Sweden.

The use of the cornerstone model provides a framework to illustrate the application of TQM in preschools.

Principals struggle to find time for systemic quality work. The presented results can be used to work systematically with quality in preschools and other organizations.

The purpose of this study is to explore the concept of long-term thinking in a non-business context to gain deeper insights into bridging the gap between the theory of long-term thinking and its application as a management strategy.

To explore the concept of long-thinking further in a non-business setting, a grounded theory study was conducted with preschool leaders in a municipality in Sweden to examine how the leaders describe, define and apply the concept of long-term thinking in their schools. Interviews with school leaders, both written and oral, were used for data collection.

This study illustrates that the concept of long-term thinking can be twofold. First, the description can be as an anchor that reflects a mission. Second, the description can be a steering mechanism that guides decision-making. The findings also reinforce the importance of organisations developing an organisational culture that connect their vision and goals with the values and needs of their customers.

This study was carried out in a single organisation and shows a snapshot of the organisation's status at the time the data were collected. Therefore, the findings are not generalisable to all organisational settings; rather the findings may be transferable to other settings.

The results can be used to help identify areas where preschools in a municipal context can engage with sustainable quality development in order to build systems that support work with quality in a more structured way.

Long-term thinking is seen, within both theory and organisations, as necessary to achieve success in terms of sustainable development and quality, and this study contributes with knowledge about the current gap between theories of long-term thinking and practice in organisations.

The purpose of this study is to develop a model describing different factors that affect quality and efficiency in transitional care.

A meta-synthesis focusing on the transitions between wards was conducted within a research project. The results from eight studies within that research project have been combined and analysed from a holistic view.

The findings are a model with a description of seven different categories consisting of the identified factors affecting quality and efficiency in transitional care. Those categories are (1) learning organisation, (2) standardising and structuring, (3) applying a holistic view, (4) understanding organisational culture in a health care context, (5) management and leadership, (6) for whom value is created and (7) working together. The results from the study have been verified in previous research.

The result of the completed meta-synthesis is based on studies conducted at two medium-sized hospitals in Sweden. The developed model can be used in a similar context to improve quality and efficiency in patient transfers by management and employees working based on the various factors.

This model describes factors (success factors, prerequisites, conditions and lack thereof) affecting the ability to achieve quality and efficiency in transitional care that can be used in future research as well as for practical improvements.

Today’s organisations face the challenge of measuring the right things and then using those measurements as a starting point to work with improved quality. The failure to generate a shared value base is pointed out as one main cause for the inability to effectively apply quality management and lean within organisations; thus, it appears central to measure these values. However, the measuring of values and behaviours seems to be missing within both concepts. Therefore, there is a need for a tool that measures not only quality values but also behaviours that support or obstruct a quality culture. The purpose of this paper is to describe how a measuring tool which measures quality culture can be designed and structured.

A project with the aim to measure and develop quality culture started in 2015 by three Swedish universities/institutes and seven organisations. During several workshops, quality values and supportive and obstructive behaviours were developed and described. This resulted in a survey where employees of the participating organisations ranked performance and importance of the described behaviours. The results were presented and discussed in a fourth workshop.

A framework of behaviours and a measurement tool for a quality culture are presented in this paper.

The framework of behaviours, supporting or obstructing a quality culture, is original and may be very useful to diagnose and develop a quality culture.