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This study aims to deepen the understanding of how top managers reason about handling the relationships between quality of patient care, economy and professionals’ engagement.

Qualitative design. Individual in-depth interviews with all members of the executive management team at an emergency hospital in Norway were analysed using reflexive thematic method.

The top managers had the intention to balance between quality of patient care, economy and professionals’ engagement. This became increasingly difficult in times of high internal or external pressures. Then top management acted as if economy was the most important focus.

For health-care top managers to lead the pursuit towards increased sustainability in health care, there is a need to balance between quality of patient care, economy and professionals’ engagement. This study shows that this balancing act is not an anomaly top-managers can eradicate. Instead, they need to recognize, accept and deliberately act with that in mind, which can create virtuous development spirals where managers and health-professional communicate and collaborate, benefitting quality of patient care, economy and professionals’ engagement. However, this study builds on a limited number of participants. More research is needed.

Sustainable health care needs to balance quality of patient care and economy while at the same time ensure professionals’ engagement. Even though this is a central leadership task for managers at all levels, there is limited knowledge about how top managers reason about this.

This study aims to analyse student and teaching staff views on how higher education (HE) can contribute to sustainable development, and to provide examples of how a medical university has adopted the sustainable development goals (SDGs) as part of its institutional strategies and practises.

The study is based on participant views from a conference, which aimed to identify actions needed for HE to contribute to the SDGs. More than 500 students, teachers and academic leaders participated at workshops to discuss and reflect on the role of higher education institutions (HEIs) in sustainable development. The discussion key points were recorded on flipcharts, and the analysis builds on all written statements from the nine workshops. Based on the findings from the workshop, steering documents and activities of a medical university were identified as examples of implementation.

Two overarching interdependent themes were identified and indicated a need to rethink the role not only of HE per se but also that of HEIs at large, to meet the challenges of sustainable development. The study also provides an example of how such organizational change can be practically implemented at a medical university, through the establishment of overarching institutional strategies, funding opportunities and external collaborations.

The findings reflect a “bottom-up” call from students and educational staff for HEIs to step up and contribute to systems change – both through a change in pedagogies, as well as through an institution-wide approach and a shift in the role of HEIs in society.

The study is unique in providing an exemplar of the implementation of sustainable development in HE at a specific medical university.

The purpose of this paper is to explore factors influencing early implementation and intermediate outcomes of a healthcare-academia partnership in a primary healthcare setting.

The Academic Primary Healthcare Network (APHN) initiative was launched in 2011 in Stockholm County, Sweden and included 201 primary healthcare centres. Semi-structured interviews were conducted in 2013-2014 with all coordinating managers (n=8) and coordinators (n=4). A strategic change model framework was used to collect and analyse data.

Several factors were identified to aid early implementation: assignment and guidelines that allowed flexibility; supportive management; dedicated staff; facilities that enabled APHN actions to be integrated into healthcare practice; and positive experiences from research and educational activities. Implementation was hindered by: discrepancies between objectives and resources; underspecified guidelines that trigger passivity; limited research and educational activities; a conflicting non-supportive reimbursement system; limited planning; and organisational fragmentation. Intermediate outcomes revealed that various actions, informed by the APHN assignment, were launched in all APHNs.

The findings can be rendered applicable by preparing stakeholders in healthcare services to optimise early implementation of healthcare-academia partnerships.

This study increases understanding of interactions between factors that influence early stage partnerships between healthcare services and academia in primary healthcare settings.

The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

In total, 18 of Sweden’s 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians’ sickness certification practice. A discourse analysis approach was used for data analysis.

Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes “physician” or “non-physician” to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of “yes, but […]” approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers.

Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians.

The results suggest that there is a need to address the organisational conditions for managers’ role taking in healthcare organisations.

Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.