Article

The scaling-up of Neighbourhood Care: From experiment towards a transformative movement in healthcare

April 2017
Futures 89

DOI:10.1016/j.futures.2017.04.004

Authors:

Francoise Johansen

Erasmus University Rotterdam

Suzanne Van den Bosch

SUSi / HEALTi

To meet present and future challenges in healthcare, radically new approaches are needed that contribute to transforming the healthcare system. In the Netherlands this transition was envisioned by the Transition Programme Long-term Care (2007–2010) as “a fundamental change towards a more human centred, affordable and socially embedded healthcare system”. One of the experiments in this programme was Neighbourhood Care (in Dutch “Buurtzorg”): small-scale, self-managed teams of nurses who provide high-quality homecare in neighbourhoods. This article looks at Buurtzorg from the perspective of transition studies, building on the framework of ‘deepening, broadening and scaling-up’ transition experiments. We analyse how Buurtzorg could rapidly develop from a local experiment to a network of more than 800 teams and also spread to different care domains and abroad. The rapid development of Buurtzorg is explained by identifying their strategic activities, the alignment of contextual factors and their strategic position as outsider towards the regime. We conclude that Buurtzorg has become a ‘symbol’ in a transformative movement that can contribute to a future transition in healthcare. This case study contributes to theoretical and practice-oriented knowledge on how a transition experiment in a social domain can surpass the experimental phase, identifying key strategic activities for niche-mainstreaming.

Success factors for multi-actor, community-based business models focusing on eHealth: a scoping review

Conference Paper

May 2021

Objectives: This paper describes the preliminary findings of the first phase of our research project to distill the success factors and barriers for multi-actor, community-based business models focusing on eHealth. With this first phase, our objective is to defragment the literatures relating to eHealth implementation (Ross et al., 2016) and synthesize findings from various domains relating to multi-actor, community-based business models. Our research provides an exciting opportunity to advance our understanding of stakeholders’ active participation in collaborative value creation (Lumpkin & Bacq, 2019) and new organizational forms (Daskalaki et al., 2015). Prior work: To the best of our knowledge, little research addresses the intersection of several disciplines and how they influence multi-actor community-based business models that focus on (preventive) eHealth. Preventive eHealth solutions are seen as instruments to make health care future-proof (Broerse and Bunders-Aelen, 2010, Johansen and van den Bosch, 2017). The COVID-19 outbreak showed the importance of such instruments in managing health, accelerating its usage and need for implementation (Khandelwal et al., 2021). Research into collaborative business models addresses sustainability (Rohrbeck et al., 2013) and social (Austin and Seitanidi, 2012b, Austin and Seitanidi, 2012a) issues. There is an increasing understanding of the importance of end-user-centric approaches focusing on collaboration in the health domain (Cyril et al., 2015). A challenging aspect is that these domains are diverse, have different foci, use a variety of terminology and definitions and integration and consensus seem to be lacking (Ross et al., 2016, de Man and Luvison, 2019). Moreover, it remains unclear how eHealth applications influence such multi-actor community-based business models and influence the success factors and barriers to the best of our knowledge. A better understanding of these developments and the underlying drivers and impediments will help determine the success of multi-actor, community-based business models focusing on eHealth. Approach: We use an explorative longitudinal case study design with a mixed-method approach. We employ a systematic literature review of which the outcomes provide the basis for our qualitative (semi-structured interviews) and quantitative (survey) research. We use Fuzzy Set Qualitative Comparison Analysis (FsQca) to assess the combinations of necessary and sufficient conditions producing multi-actor community-based business models focusing on preventive eHealth. In this paper, we report our current undertakings in preparing and conducting our systematic literature review. The research question guiding this is: which conditions that influence multi-actor, community-based business models focusing on eHealth can we derive from the relevant literatures? Results: Our research project has just started, and we are in the middle of our systematic literature review. Our preliminary findings indicate the diversity of the related domains and topics, providing ample indication for conducting a systematic literature review. We trust that these outcomes will contribute to synthesizing and mapping the various disciplines to contribute to a more holistic overview of the various conditions when developing collaborative eHealth business models. Implication and value: The literature review provides an overview of the factors influencing the successful implementation of preventive e-health applications for local communities. With this first step, we map and integrate the essential conditions from the literatures on (e)Health innovations and business models, providing an overview that future research can use (Whetten, 1989). This overview will help scholars and practitioners to focus on the relevant design issues designing preventive e-health applications and organizational arrangements.

Institutional rules for the up-take of regulatory experiments: A comparative case study

Article

Feb 2024
FUTURES

Experiments are an important governance instrument for fostering learning between actors, improving governance, and managing transition pathways for sustainable development. However, determinants of the up-take of the result of experiments are underexplored in the transition experimentation literature. Consequently, we explore the role of experimental design and institutions in this up-take. This paper examines the following research question: How is the up-take of regulatory experiments for sustainability transitions influenced by their design elements and what role do institutions play? The paper uses comparative qualitative content analysis to examine 27 international regulatory experiments. In analyzing the up-take of experiments, we focus on three dimensions: transferability, scalability, and unintended consequences. The analysis demonstrates that the transferability of regulatory experiments depends on its regulatory and geographical context as well as its timeframe and the selection of participants. The scalability appears to be mainly influenced by the timeframe and timing of the regulatory experiment as well as the communication of the experimenters with stakeholders and the support of political actors. Furthermore, the influence of unintended consequences from regulatory experiments depend on the diversity of the participants, the communication of the involved actors, and the use of several design options. Our results can inform policymakers and stakeholders about the design and role of institutions in regulatory experiments.

From citizen initiative to a multi- actor business model Conditions and context for successful development and implementation of a community- based eHealth business model aimed at positive health promotion in neighborhood communities

Conference Paper

Full-text available

Jun 2022

Our practice-based research provides an exciting opportunity to advance our understanding of stakeholders' active participation in collaborative value creation and new organizational forms. This paper describes the preliminary findings and experiences of a participatory action research project's first phase to distill the success factors and impediments in establishing a multi-actor, community-based business model focusing on positive health promotion by using eHealth. With this first phase, our objective is to establish a shared view on the participatory action research's design and denote the emerging themes to take on collaborative action. Moreover, by using a scoping review, we aim to defragment the literatures from various domains relating to multi-actor, community-based business models and the formalization of citizen initiatives and synthesize these findings. To collect the data, we are using a mixed-method approach. We use a Participatory Action Research (PAR) design and follow a citizen initiative in-depth. This paper reports our multiple activities to date to co-create the PAR-design to be used and prepare and conduct our scoping review. The research question guiding this is: how to collaboratively set up the Participatory Action Research Design to accelerate a local citizen initiative's business model development process by empirically validating the conditions that influence multi-actor, community-based business models focusing on eHealth? We trust that these outcomes will contribute to synthesizing and mapping the various literatures to contribute to a more holistic overview of the various conditions when developing collaborative eHealth business models. Likewise, the outcomes of this collaborative process will be useful for further research as well, as it highlights the interdependencies in such a multidimensional and complex process.

Dissertation: Seed Commons in the Multi-Level Governance Regime: Creating Empowering Institutions for a Social-Ecological Transformation of Agri-food Systems

Preprint

Full-text available

May 2021

Julia Tschersich

This cumulative dissertation (status: submitted) analyzes the transformative potential of Commons approaches in plant breeding, seed production or conservation (so-called Seed Commons) as alternative Governance approaches to tendencies of privatization and enclosure in the seed sector and the wider agri-food system. For this purpose, on the basis of a literature review, first a conceptualization of a social-ecological transformation (SET) is developed that allows to assess the contribution of small initiatives to a wider transformation. The proposed conceptual SET framework also contributes to connecting the strengths of diverse transformation literatures. In a comprehensive transdisciplinary process, a concept for 'Seed Commons' is developed that highlights shared characteristics of diverse Seed Commons initiatives. Seed Commons can be characterized by four criteria: by recognizing a collective responsibility for the conservation and further development of cultivated plants and genetic diversity, by protecting seeds and varieties from legal or (bio-)technological enclosure, through collective, polycentric management and by sharing formal and practical knowledge within and/or beyond the initiative. These criteria are suitable for a stringent analysis of the shared challenges and opportunities of Seed Commons initiatives. In the next step, I apply these Seed Commons criteria in a systematic document analysis to examine how the complexity of the multi-level governance regime around seeds, biodiversity and intellectual property rights impacts Seed Commons initiatives in Germany and the Philippines. The results show that especially the patent and variety protection regime as well as strict requirements for marketing of seeds can threaten central practices such as the sharing of seeds or their on-field adaptation and further development. Yet the impact of norms such as the conservation of biodiversity and farmers' rights of the biodiversity convention and the international Seed Treaty also contribute to exceptions that widen the scope of action of Seed Commons. Finally, this thesis highlights the very creative, differentiated and conscious ways in which Seed Commons initiatives deal with these incumbent institutional frame conditions, i.e. by resisting them or using gray areas. Through their alternative, everyday practices, they contribute to institutional and political change. Hence Seed Commons initiatives challenge dominant structures by disputing incumbent practices, rules and norms and creating a real and viable alternative on the ground. Overall this thesis shows, taking the example of Seed Commons initiatives, that even small initiatives can contribute to a social-ecological transformation, when they confront incumbent structures, institutions and paradigms, and create just and resilient alternatives. If you are interested in reading the introductory chapter to my cumulative dissertation, feel free to get in touch! (problem statement, main results and contributions, discussion of transdisciplinary methodology, future research avenues etc.) Three of the four papers of the cumulative thesis have (so far) been published, all open access. See below (also on my RG profile): - Tschersich, J. (2021). Norm conflicts as governance challenges for Seed Commons: Comparing cases from Germany and the Philippines. Earth System Governance, 7, 100097. https://doi.org/10.1016/j.esg.2021.100097 - Sievers-Glotzbach, S., Tschersich, J., Gmeiner, N., Kliem, L., & Ficiciyan, A. (2020). Diverse Seeds – Shared Practices: Conceptualizing Seed Commons. International Journal of the Commons, 14(1), 418–438. DOI: http://doi.org/10.5334/ijc.1043 - Sievers-Glotzbach, S. and J. Tschersich (2019): Overcoming the process-structure divide in conceptions of social-ecological transformation: Assessing the transformative character and impact of change processes. Ecological Economics 164. https://doi.org/10.1016/j.ecolecon.2019.106361

Transition in the Dutch Preventive Child Health care: a study on the Health Deal I-JGZ for scaling up digital innovations and combating digital fragmentation

Thesis

Full-text available

Jul 2020

Danique Heemskerk

How Does Social Innovation Cross Borders? Exploring the Diffusion Process of an Alternative Homecare Service in France

Article

Sep 2019

The aim of this paper is to present initial findings from an exploratory case study analyzing the process of emergence and diffusion of a new homecare service in France. In healthcare delivery, innovations aiming to tackle structural aspects of the system can take the form of social innovation. Social innovation is generally defined as a process, rather than an outcome, creating strategies that reconfigure social relations to meet a social goal. Buurtzorg Nederland is an example of such innovation. Launched twelve years ago in the Netherlands by a small team of four, this innovative homecare organization now includes over 10,000 self-managed nurses providing efficient value- and team-based care to patients in their homes, empowering both staff and patients. Today Buurtzorg Nederland has grown and been transposed to other countries, but few studies describe the process of adoption. This paper explores how Buurtzorg has been adapted in France since 2017. JEL Codes: O35, I18, I1, O0

Overcoming the process-structure divide in conceptions of Social-Ecological Transformation Assessing the transformative character and impact of change processes

Article

Full-text available

Jun 2019
ECOL ECON

A fundamental transformation towards sustainability in face of complex social-ecological challenges needs to initiate deep changes of those incumbent system structures that support unsustainable trajectories, while at the same time encouraging a diversity of alternative practices. A review of transformation approaches towards sustainability shows that these do not (sufficiently) link processes of change at the micro level to deep leverages of change in wider system structures. Addressing this research gap, we develop a conceptual framework for a social-ecological transformation that connects the macro and the micro level and helps to bridge process-oriented and structural approaches to transformation. At the macro level, the objectives of inter-and intragenerational justice need to be pursued by challenging the central paradigms that constitute unsustainable trajectories. To make the framework concrete and applicable in practice, we propose a preliminary set of evaluation principles for the micro and meso level that reflect these normative objectives and help to measure the transformative character and transformative impact of change processes. The example of the European Organic Breeding Network illustrates the application of the framework. An Ecological Economics research that is reflective of its transformative quality in light of the incumbent paradigms can make important contributions to transformation research.

Transition Pains: Recognizing Employee Reactions to Organizational Realignment in a Disruptive Context

Article

Full-text available

Feb 2024
J Appl Behav Sci

This paper introduces the use of a pain analogy in exploring employee reactions in organizational change processes. Perceiving the signaling function of an individual pain experience as a call to action, we present a conceptualization of transition pains: emotional pain experienced by organizational members related to processes of change in the context of disruptive external change (i.e., transition). The transition context leads to realignment of strategy, policies and work organization. When these are not aligned or even contradictory, this creates confusion and an individual can experience incongruences. Pain symptoms such as tension or stress may act as signals that there is an imbalance between job demands and resources. This perspective supports practitioners in the interpretation of responses during a change process and offers interventions focused on developing resources and reducing incongruences.

Insights into the configurations to create and capture value for preventive e-health applications: a Fuzzy Set Qualitative Comparison Analysis (FsQca)

Conference Paper

Full-text available

Nov 2021

There is a need for preventive health care solutions to address issues that threaten the health care system’s long-term sustainability, for instance, aging, lack of inclusivity, and rising costs (Broerse & Bunders-Aelen, 2010; Johansen & van den Bosch, 2017). A promising solution may lie in community-based preventive eHealth business models. Especially business models that create an ecosystem where relevant stakeholders co-create value within their community (Lumpkin & Bacq, 2019). However, there is a lack of research on developing such initiatives and how to manage the multi-actor complexity involved (Gjellebæk et al., 2020; van Limburg et al., 2011). Our objective is to gain more knowledge about which configuration of conditions is associated with successfully implementing a multi-actor business model that focuses on preventive eHealth in local communities. We use a configurational approach to explore the interplay of conditions creating simultaneous value. The conditions we use result from a systematic literature review. Accordingly, we contribute to the call for defragmenting the literatures related to e-health implementation and a better understanding of factors and strategies influencing this (Ross et al., 2016, p. 2). Our research provides an exciting opportunity to advance our understanding of stakeholders’ active participation in collaborative value creation (Lumpkin & Bacq, 2019) and new organizational forms (Daskalaki et al., 2015).

The transformative potential of Seed Commons: Applying the social-ecological transformation framework to agri-food systems

Article

Full-text available

Jan 2023
J RURAL STUD

In this paper, we argue that small initiatives can contribute to larger transformations if they challenge and unmake incumbent unsustainable paradigms, and we demonstrate how the application of the social-ecological transformation framework helps to operationalize the analysis of paradigm shifts across different levels of transformation. Empirically, we assess the contribution of Seed Commons initiatives to agri-food systems transformations, taking the case of the organic breeding association Kultursaat e.V. At the macro level, the analysis reveals that the paradigms of 'materialistic culture and growth', 'control and autonomy of humans over nature' and 'expert knowledge and specialization' are deeply embedded in the dominant agri-food system. Kultursaat challenges them by promoting alternative narratives such as agroecology, food sovereignty, farmers' rights and resilience. At the micro and meso level, we apply a set of evaluation principles that reveal the transformative character and partial transformative impact of Seed Commons. Applying the framework to agri-food systems can bring an enhanced theoretical understanding of dynamics of change into the agri-food transformation discourse, link small-scale initiatives to wider processes of transformation, and provide a systematic research approach to enhance comparability across case studies. The framework is well suited to bring together even evolving transformation literatures.

Value Driven Transformation of Care Work – A Use Case

Chapter

Sep 2022

A holistic design of person-related services, like care work, requires a combined vision, that takes into consideration the customer’s, as well as the care-giver’s, and the organizational perspective. This is especially important when agile and collaborative work-systems are being implemented in person-related service systems, as different perspectives - and therefore beliefs, needs and values of the people involved - are to be considered. This paper presents a new perspective on values that need to be mapped and shaped when agile work systems in care-giving services are being designed. As a result, it describes a transformational process that has, at its center, concrete collaboration and service values out of which practical implications and an organization (re-)design process is deduced. This leads to a value-driven transformational process that takes into account all aspects of an organization to sustainably develop person-related service systems and that challenges existing service management and design approaches.KeywordsValue mappingCare-giving servicePerson-related serviceAgile work systems

Discretion of the Future: Conceptualizing Everyday Acts of Collective Creativity at the Street‐Level

Article

Full-text available

Apr 2021

Although scholars and practitioners promote creative uses of discretion in the delivery of public services, there is limited empirical research that explains through which activities street‐level practitioners develop creative solutions. Based on over 300 hours of ethnographic observations of child and family practitioners, we demonstrate the pattern of collective and deliberate experimenting that encompasses creative discretion. The development of this subtype of discretion helps to better analyze and perform it, while simultaneously nuancing the potential positive outcomes of creative uses of discretion for public service provision. Additionally, we explain the collective nature of creative discretion, which has important implications for both research and practice of creativity at the street‐level. Finally, we show that street‐level practitioners become architects of the political and organizational system in which they work by changing the rules and provision, the organization of work, and the development of policy through their performance of creative discretion. This article is protected by copyright. All rights reserved.

A System Innovation Perspective on the Potential for Scaling Up New Psychological Interventions for Refugees

Article

Full-text available

Apr 2021

In recent years, a range of brief protocolised psychological interventions like Problem Management Plus have been developed. Such "scalable psychological interventions" are meant to be delivered by nonspecialists which can greatly increase access to psychological therapies for people affected by adversity, including forced displacement. However, embedding new interventions into mainstream practices is challenging. Novel interventions can remain in the research phase for a long time or stop altogether, which minimises their intended impact and reach. In this conceptual paper we propose a "system innovation perspec-tive" on scaling up new psychological interventions for refugees and argue that existing mental health systems often need to change to integrate new interventions in a sustainable way. We present a conceptual framework, which includes ideas on cycles of deepening (learning by doing), broadening (repeating and linking), and scaling up (embedding) and the multilevel and constellation perspective. This framework has been operational-ised in our scalability research as part of the STRENGTHS study in which we increase our understanding of the opportunities for scaling up four new psychological interventions in eight countries hosting Syrian refugees, including in Europe (Germany, Netherlands, Sweden and Switzerland) and the Middle East (Egypt, Jordan, Turkey and Lebanon).

A multilevel transition perspective on embedding intersectoral action in local health policies

Article

Full-text available

Dec 2020

Intersectoral action is advocated as a social practice that can effectively address health inequalities and related social issues. Existing knowledge provides insight into factors that may facilitate or hinder successful intersectoral action, but not much is known about how intersectoral action evolves and becomes embedded in local health policies. This is where this study aims to make its contribution, by adopting the multilevel perspective on transitions, which is increasingly used to study social innovation in sustainability transitions but has not yet been applied to public health and health promotion. Through this perspective, it was unravelled how intersectoral action between youth-care organizations and community sports clubs became embedded in local health policies of Rotterdam, a large city in the Netherlands. A single explorative case study was conducted based on content analysis of policy documents and 15 in-depth interviews with policy officers, managers and field workers operating in the fields of youth and sports in Rotterdam. The findings showed that intersectoral action between community organizations and policymakers evolves through congruent processes at different levels that changed institutional logics. Moreover, it emerged that policymakers and other actors that advocate novel social practices and act as boundary spanners can adopt multiple strategies to embed these practices in local health policy. The multi-level perspective adds value to earlier approaches to research intersectoral collaboration for health promotion as it allows to better capture the politics involved in the social innovation processes. However, further sharpening and more comprehensive application of transition concepts to study transitions in public health and health promotion is needed.

Türkiye’nin Evde Bakım Paradoksu: Buurtzorg Modeli Üzerine Bir Politika Değerlendirme Araştırması

Article

Full-text available

Aug 2024

İbrahim Hüseyin Cansever

Türkiye, yaşlı nüfusun her geçen yıl artmasıyla çok yaşlı ülkeler kategorisine geçiş yapmıştır. Ülkelerin artan yaşlı nüfuslarıyla birlikte uzun süreli bakım hizmetlerine olan ihtiyaç önemli ölçüde artmaktadır. Türkiye’de de özellikle kadınlara yüklenen ve aile içi görev olarak görülen uzun süreli bakım hizmetlerine olan talep, geniş ailelerin çekirdek ailelere dönüşmesi ve kadınların ev dışında işlerle daha fazla ilgilenmesi gibi nedenlerle artmaktadır. Türkiye’de son dönemde ortaya konulan belgelerle yaşlıların yerinde bakımı yani evde bakım ve sağlık hizmetlerine yönelik dönüşüm yaşanmakta olduğu açıkça görünmektedir. Ancak hâlihazırda bu dönüşüm öncesi birçok konuda sorunların varlığı açıktır. Araştırmanın temel amacı, Hollanda’da uygulanmakta olan Buurtzorg modelinin politika (program) değerlendirme yöntemiyle analiz edilmesidir. Araştırma ile Türkiye’nin evde bakım sisteminde var olan sorunlarına, mevcut durumda ayakları yere basan bir evde bakım sistemine sahip olan Hollanda’daki Buurtzorg modelinin, politika (program) değerlendirilmesi ile birçok çözüm önerisi ortaya konulmaya çalışılmaktadır. Araştırma; sistem, uygulama ve yararlanıcılar olmak üzere üçlü bir sacayağı üzerine oturmaktadır. Amaca yönelik olarak veri toplama tekniği olarak doküman incelemesi yönteminden faydalanılmıştır. Araştırmanın sonucunda sistem, uygulama ve yararlanıcılar boyutunda çeşitli politika önerileri ortaya konuşmuştur.

Stumbling between Energy Economy and Energy Democracy: Assessing the Transformative Character and Impact of German Energy Cooperatives

Thesis

Full-text available

Nov 2022

Tobias Biener

Germany's energy system is undergoing significant transformations driven by the Energiewende, a comprehensive transition to renewable energy sources. This thesis investigates the role of energy cooperatives (ECs) in this transition, specifically examining whether they serve as social-ecological transformative actors challenging the traditional Energy Economy and contributing to an Energy Democracy. Utilizing an analytical framework based on the social-ecological transformation and the concepts of Energy Democracy and Energy Economy, a systematic review was conducted on the empirical state of German ECs. The findings reveal that while ECs possess transformative elements such as regionality, collaboration, and environmental consciousness, they do not significantly challenge established social-ecological inequalities. ECs exhibit a high degree of social exclusivity and face substantial barriers in influencing political and economic contexts. Consequently, although ECs are not fully transformative actors, they do contribute to the advocacy for a decentralized and collectively managed energy system, embodying the principles of Energy Democracy within the constraints of the existing capitalistic driven Energiewende.

Scaling-up problem management plus for refugees in Switzerland - a qualitative study

Article

Full-text available

May 2023
BMC HEALTH SERV RES

Background Refugees are at an increased risk of developing symptoms of mental disorders but face various structural and socio-cultural barriers to accessing mental health care. The SPIRIT project (Scaling-up Psychological Interventions in Refugees In SwiTzerland) seeks to promote the resilience of refugees and improve their access to mental health care. For this purpose, Problem Management Plus (PM+), an evidence-based low-intensity psychological intervention delivered by trained non-specialist “helpers”, is being scaled-up in Switzerland. Objective To identify factors influencing the process of the large-scale implementation of PM + for refugees in Switzerland and to develop recommendations to guide the implementation process. Methods 22 semi-structured interviews were conducted with key informants (Syrian refugees who previously participated in PM+, PM + helpers, health professionals working with refugees and decision-makers from the migration, integration, social, and health sectors). The data were analyzed using thematic analysis, combining an inductive and deductive approach. Results The data revealed three major themes, which might have an impact for the longer-term implementation of PM + in Switzerland. First, preconditions for successful integration in the health system prior to scaling-up such as sustainable funding or the introduction of a stepped care approach. Second, the requirements for the PM + intervention supporting scale-up such as quality control during PM + delivery, PM + modality, time and setting when PM + is offered or the views on task sharing. Third, the perceived benefits of scaling-up PM + in Switzerland. Conclusions Our results have shown that PM + must be scaled-up within a stepped care approach, including a functioning triage system and sustainable funding. Rather than selecting one modality or setting, it seemed preferable to offer a variety of formats and settings to achieve maximum reach and benefits. A successful scale-up of PM + in Switzerland might have various benefits. Communicating them to policy-makers and health providers, might enhance their acceptability of the intervention and their willingness to adopt PM + in regulatory structure and promote it.

Quand l’économie sociale et solidaire rencontre la libération d’entreprise. Entre commun et agonisme : une analyse démocratique de deux organisations alternatives

Thesis

Full-text available

Sep 2022

Kévin Pastier

Cette recherche porte sur l’association de deux objets de gestion : l’entreprise de l’ESS, à la gouvernance démocratique, et l’entreprise libérée, prônant une organisation managériale libératrice et émancipatrice. Alors que le fonctionnement démocratique de la première semble condamner à la dégénérescence par la littérature, nous montrons que ce déterminisme s’appuie sur un impensé : une organisation démocratique du travail. Parallèlement, l’entreprise libérée, dernière mode managériale contemporaine, est amplement critiquée par la littérature scientifique. En particulier, nous montrons que ses partisans se sont contentés d’une « libération » de l’organisation du travail. Il existe de fait un plafond de verre de la gouvernance d’entreprise. Ces deux catégories organisationnelles semblent donc complémentaires et leur association constitue une réunion originale pour repenser l’organisation et la gestion de l’entreprise. Pour étudier le potentiel démocratique de cet objet de gestion unique, cette recherche mobilise une double approche théorique démocratique : les communs et l’agonisme. D’un point de vue empirique, nous nous appuyons sur une étude de deux cas d’entreprise : un supermarché coopératif, mettant en place une organisation sociocratique et holacratique, et une entreprise sociale du secteur de l’aide à domicile, entreprise commerciale de l’ESS organisée par équipe autonome. Cette thèse propose une triple contribution. Tout d’abord, nous analysons le potentiel démocratique d’une ouverture de la gouvernance au sein de l’entreprise libérée. Ensuite, nous contribuons à approfondir le fonctionnement démocratique des entreprises de l’ESS. Plus précisément, cette thèse permet de réexaminer la théorie de la dégénérescence. Enfin, nous dévoilons des conditions, des effets et des enjeux d’une démocratisation organisationnelle de l’entreprise.

Positieve Gezondheid: Verandering van taal in de gezondheidszorg

Article

Full-text available

Oct 2022

Present and Future Trends of Sustainable Eldercare Services in China

Article

Full-text available

Jul 2022

Ageing population is one of the most fundamental socio-economic transformations of the twenty-first century, with significant policy implications. China, the world’s most populous nation, is no exception. The necessity for cost-effective, culture-appropriate and sustainable eldercare services is one of the Government’s priorities, in both present and future. This research uses a focus-group interviews methodology to explore sustainable models of eldercare services through an in-depth comparative analysis of care demands and service provision in two Chinese cities. The study reflects a prevailing trend of the integrated-care service mix in line with the United Nations’ five most relevant Sustainable Development Goals (SDGs 1, 3, 5, 10, 11) for older adults. In addition to the 7Ps of the service marketing mix, this article highlights the particular importance of ‘Partnership’ in sustainable care delivery in China. The past-present-future scenario and the thematic analysis of older adults’ pattern-matching add two unique dimensions to population ageing and eldercare studies: ‘People’ and ‘Partnership’.

Inquiry of the Practice of Leadership in Chengguan: A Study Based on the Ethnographic Research of Z City

Article

Full-text available

Jun 2022

Chengguan, the Urban Administrative Law Enforcement Bureau, has been criticized for its dismal public image and poor job performance. Based on an ethnographic case study in Z City, we analyzed the type of leadership that results in passive work performance in Chengguan, and we examined whether any leadership style can be used to improve Chengguan's image and performance. We developed a new leadership ontology of CNP (Cognition–Normalization–Performance) on this foundation, and ethnographic research was conducted in three phases: leader's cognition, followers' normalization, and organization performance. Several implications were drawn. Leader selection should be cautious and can be improved by studying the leader's traits and behavior. This is done by investigating candidates' leadership career paths, trait characteristics, motive profiles, and other qualities. It is useful to change leaders by strengthening followers' unity and cohesion by setting up a labor union, youth federation, women's federation, and other groups. A leader should be selected among individuals who have completed leadership training as opposed to appointing one from outside the organization. On the one hand, the superior should help to improve the leadership environment (context), supervise problems in the organization's operation and performance, and track changes over time. On the other hand, the leader can also provide the followers with a flexible and adaptive place of work.

Just What the Doctor Ordered – Towards Design Principles for NLP-Based Systems in Healthcare

Chapter

May 2022
Lect Notes Comput Sci

Patient data is mainly transmitted in the form of unstructured free texts in medical documentation. Natural language processing (NLP)-based systems can help to structure and extract information from these free texts to support the work of healthcare professionals. However, the healthcare sector must meet certain information quality requirements to comply with regulations and provide optimal patient care. Therefore, we argue that a design guideline is needed to tailor NLP-based systems to the unique requirements of clinical processes and to catalyze the practical application of such systems. In this paper, we report the results of a design science research study, focusing on the requirements of NLP-based systems used by healthcare professionals. In doing so, we shed light on the needs of practitioners when working with sophisticated NLP-based systems that extract and analyze text-based information from medical documentation. By providing evaluated, testable propositions and detailed design principles, we support the practical endeavor of such systems.KeywordsHealthcareNatural language processingDesign principles

Social Obstetrics as Niche-Development in Addressing Health Inequities

Article

Full-text available

Nov 2021

We apply a transition research perspective to the Dutch obstetric care system to analyze historic, current, and future shifts and find ways to overcome persistent health inequities. We present social obstetrics as an emerging niche that addresses perinatal health inequities by acknowledging their multifaceted origins and fostering collaborations across the medical, social, and public health sectors. We conducted desk research, in-depth semi-structured expert interviews, and interactive group sessions with change-inclined professionals that are relevant for the implementation of social obstetrics in six Dutch municipalities. The outcomes are synthesized in a historical narrative and perspectives on current obstacles and future systemic shifts. We argue that social obstetrics can be considered a sustainable addition to what is already present, instead of a disruptive transformation of the current system. Social obstetrics is innovative as it connects various societal systems and offers a framework for cross-sectoral collaboration. These collaborations, in turn, can be the starting point for the transformation of the obstetric care system as well as other relevant societal systems.

Itseohjautuvuus ikäihmisten palveluissa

Book

Full-text available

Oct 2020

Management challenges for future digitalization of healthcare services

Article

Full-text available

Dec 2020
FUTURES

eHealth is considered a solution to current challenges in healthcare. However, its use is not very well developed, and its potential has been little exploited. There are many reasons for the limited diffusion of eHealth. Knowledge, opportunities for training and collaborative activities are examples of factors that influence diffusion. Managerial responsibility is decisive in transforming healthcare. This paper aims at exploring middle management strategies that can facilitate workplace learning when introducing eHealth and new ways of providing healthcare. Introduction of eHealth will imply new and innovative working processes, where both employees and managers need to be aware that their work will change fundamentally, from routine work to work that involves learning, skills development and continuous changes in work practice. This study takes a qualitative approach by analysing data collected through focus group interviews. The findings indicate a necessity for a shift towards learning-oriented leadership and adaptive management that emphasizes employee involvement and opportunities for learning. Helping employees make sense of the complexities associated with continuously changing work practices is another identified middle management strategy. Scenario planning and backcasting stand out as suitable tools for sensemaking in complex organizations and as techniques that can promote workplace learning.

Articulating the new urban water paradigm

Article

Full-text available

Aug 2020

Urban water systems in industrialized countries have underpinned unprecedented improvements in urban living standards through effective drinking water supply, sanitation and drainage. However, conventional urban water systems are increasingly regarded as too rigid and not sufficiently resilient to confront growing social, technological and environmental complexity and uncertainty, manifested, for example, in the maladaptation to climate change, depletion of nonrenewable resources, and degrading urban livability. In response, a new urban water paradigm has emerged in the last two decades within the context of a broader societal change that promotes a more organic worldview over the classical mechanistic and technocratic understanding of reality. This article develops and applies an analytical framework to coherently describe the new paradigm and contrast it with the old urban water paradigm. The framework includes a philosophical foundation and set of methodological principles that shape the new paradigm’s approach to governance, management, and infrastructure.

A Multi-Stakeholder Perspective on Sustainable Healthcare: From 2030 Onwards

Article

Jul 2020
FUTURES

Over the past years, the interest in sustainable healthcare has been growing globally and the transition toward environmentally, economically and socially viable health systems is perceived as inevitable and necessary. All the approaches to this emerging field are mainly focusing on short-term specific issues and involving a limited number of stakeholders. This study aimed to address the topic of the possible futures of sustainable healthcare from a multi-stakeholder perspective, in order to define a long-term scenario and the key strategies to enhance this transition. A series of workshops have involved a representative selection of stakeholders based in Nordic countries and concerned with sustainable healthcare (health industries, health providers, managing authorities, universities and research centres, clusters, NGOs and healthcare networks, professional consortia) through a collaborative foresight process. A design-based approach has been adopted to investigate the current scenario and deepen foresight outcomes. The results highlighted three different horizons and the drivers to reshape the roles of individual stakeholders, enhancing the socio-technical transition towards a desirable scenario based on collaboration between distributed dynamic networks. The identified transition strategies move from the local to the international level, focusing on innovation, information and collaboration between stakeholders. This study provides the framework for future studies to deepen the transition process towards sustainable healthcare and its implications at Nordics, European and international levels.

Urban living labs as inter-boundary spaces for sustainability transitions?

Chapter

Full-text available

Jun 2020

This Handbook shows the enormous impetus given to the scientific debate by linking planning as a science of purposeful interventions and complexity as a science of spontaneous change and non-linear development. Emphasising the importance of merging planning and complexity, this comprehensive Handbook also clarifies key concepts and theories, presents examples on planning and complexity and proposes new ideas and methods which emerge from synthesising the discipline of spatial planning with complexity sciences.

The Future of Pharmaceuticals Industry within the Triad: The Role of Knowledge Spillovers in Innovation Process

Article

Jun 2020
FUTURES

The purpose of this paper is to investigate the role of knowledge spillovers on productivity returns pharmaceutical leading firms. The analysis is based upon a dataset (sourced from the EU R&D investment scoreboards) made of R&D-intensive pharmaceuticals firms. In particular, we quantify the impact of R&D spillovers on the total factor productivity (TFP) between 2002 and 2010 on the basis of technological proximity. Thus, we elaborate more future scenarios to know what will happen, what can happen and how a predefined target may be obtained. Indeed, a numerical analysis for prediction of scenarios was conducted using the Method of Least Squares. The technological relatedness between the firms is computed through an original Mahalanobis industry weight matrix, based on the construction of technological vectors for each firm (Aldieri, 2013; Jaffe, 1986). The results confirmed the leadership of Europe and the USA in the pharmaceutical sector, highlighting the innovative capacity of Pfizer. The results might be interpreted to provide some useful implications for pharmaceutical policy strategy given that mainly in the pharmaceutical industry the private sector innovations derive from public-sector research investments.

Digitalisierung, Geschlechtliche Zuweisungsprozesse und De/Professionalisierung in der Care-Arbeit

Chapter

Mar 2020

Lena Weber

Seit einigen Jahren wird international an der Schnittstelle von Ingenieur- und Pflegewissenschaften diskutiert und erforscht, inwiefern durch Technik und smarte Anwendungen Sorgetätigkeiten von Angehörigen und (bezahlten) Pflegekräften ersetzt und/oder unterstützt werden können (Bräutigam et al. 2017; Hielscher et al. 2015a, b). Der Beitrag nimmt dies zum Ausgangspunkt, die Debatte der Arbeitssoziologie zum Thema „Arbeit 4.0“, der Geschlechterforschung um die Rationalisierung von Care-Arbeit und Erkenntnisse aus den Pflegewissenschaften zur Digitalisierung zusammen zu führen. Diese werden dann u. a. mit Überlegungen von Angelika Wetterer (2002) zum Thema Professionalisierung und Geschlecht verknüpft.

Innovations in Healthcare and Wellbeing: A Focus on Actors and Collaborations at the Boundaries

Article

Sep 2019

The healthcare ecosystem faces complex and multiple challenges: increase in chronic diseases, population ageing, emergence of new issues (health promotion, ageing disability, social isolation, etc.), increase in social and territorial health inequalities, failing to seek medical treatment, increase in the cost of certain treatments, expectations for personalized approaches to care, etc., as well as the obvious financial constraints on the healthcare ecosystem...

Organized Discretion

Chapter

Aug 2019

Discretionary judgement—defined as the freedom to decide how to act within controlled limits—is increasingly being exercised in teams and networks. We introduce the notion of collective discretionary room to emphasize this relational nature of discretionary judgement. Collective discretionary room is the freedom granted to a team or a network to reach judgements to take action. In this chapter we describe the main differences between discretion as an individual asset of a worker versus discretion as collective resource of a team or network. The first difference is the aim which changes from being responsive in individual situations to improving policy designs and outcomes. The second difference entails control. Collective discretionary room merges using and controlling freedom. In addition, collective discretionary room offers mechanisms to control and enhance the quality of the working methods.

SAĞLIK TURİZMİNDE WEB 5.0’A DOĞRU GELİŞMELER: SİSTEMATİK DERLEME

Article

Oct 2023

Günümüzde internet teknolojisi hayatımızın vazgeçilmez bir parçası haline gelmiştir. Gazeteler, televizyonlar gibi geleneksel medyalara olan ilgi gün geçtikçe azalma eğilimi göstermektedir. Teknoloji bugün tüm alanlarda kullanıldığı gibi sağlık turizminde de kullanımı önemlidir. Bu kapsamda çalışma, Web 4.0 ve Web 5.0 teknolojilerinin sağlık turizmi açısından önemi, kullanım alanları ve potansiyel yeniliklerini keşfetmeyi amaçlamaktadır. Sistematik derleme yöntemi kullanılarak gerçekleştirilen bu araştırmada literatürdeki makaleler, raporlar, kitaplar ve tezler incelenerek sağlık turizminde WEB tabanlı dijital teknolojilerin kullanımına ilişkin kapsamlı bir tarama yapılmıştır. Yapılan sistematik derleme sonucunda, Metaverse, Oyunlaştırma, Sanal Gerçeklik, Sosyal Medya, Mobil Uygulamalar ve WEB teknolojilerinin sağlık turizmi açısından değerlendirilmesi muhtemel alanlar olduğu belirlenmiştir. Bu teknolojilerin sağlık turizmi alanında özellikle ülke tanıtımları, iletişim, konaklama ve güvenlik gibi konularda sağlık turistlerine rehberlik etme potansiyeli bulunmaktadır. Bu da sağlık turistlerinin tercih etme davranışını olumlu yönde etkileyebilir. Türkiye gibi sağlık turizmi açısından önemli bir ülkenin, tanıtım ve pazarlama faaliyetlerinde bu teknolojileri kullanması büyük bir avantaj sağlayabilir. Ayrıca, Metaverse, Oyunlaştırma ve Sanal Gerçeklik gibi teknolojilere yönelik projelerin desteklenmesi ve bu alanda faaliyet gösteren kurumların teşvik edilmesi, Türkiye'nin sağlık turizmi alanındaki rekabet gücünü artırabilir.

When, where, and how can land governance overcome path dependency? A trajectory of land governance change

Article

Full-text available

Oct 2023
LAND USE POLICY

Land governance deals with the intersections of policies, processes, and institutions on access, use, and interest in land and its resources. Path dependence on land governance can lead to unsustainable land control, shaping people’s livelihoods and well-being. Agency in land governance is well explored. The link between actors, their aims, and their agencies for transformative action has been established. However, these concepts have not sufficiently explained why land governance change can happen. Why certain governance is preferred over others is still open for interpretation. To address this gap, we incorporate insights from the social-ecological systems (SES) and socio-technical systems (STS) studies and add timing and strategic structures in analyzing the transformation process in land governance literature to build a trajectory of land governance changes that indicate ways out of the path dependency in land governance. The trajectory has scholarly novelty in adding ‘where’ (leverage points) and ‘when’ (triggers) to the existing strategic aspects of ‘who’ (actors) and ‘how’ (agency), and linking the four to indicate ways out of the path dependency. The agency of change in land governance emerges only when certain triggers destabilize incumbent land governance. Agencies and leverages are interrelated. Failure to gather momentum leads to inefficient utilization of design leverage, dropping key actors into a barrier of change, wasting the open moment, and missing the opportunity for change.

When, where, and how can land governance overcome path dependency? A trajectory of land governance change

Preprint

Full-text available

Mar 2023

Land governance deals with the intersections of policies, processes, and institutions on access, use, and interest in land and its resources. Path dependence on land governance can lead to unsustainable land control, shaping people's livelihoods and well-being. Agency in land governance is well explored. The link between actors, their aims, and their agencies for trans-formative action has been established. However, these concepts have not sufficiently explained why land governance change can happen. Why certain governance is preferred over others, which is still open for interpretation. To address this gap, we incorporate insights from the social-ecological systems (SES) and socio-technical systems (STS) studies and add timing and strategic structures in analyzing the transformation process in land governance literature to build a trajectory of land governance changes that indicate ways out of the path dependency in land governance. The trajectory has scholarly novelty in adding 'where' (leverage points) and 'when' (triggers) to the existing strategic aspects of 'who' (actors) and 'how' (agency), and linking the four to indicate ways out of the path dependency. The agency of change in land governance emerges only when certain triggers destabilize incumbent land governance. Agencies and leverages are interrelated. Failure to gather momentum leads to inefficient utilization of design leverage, dropping key actors into a barrier of change, wasting the open moment, and missing the opportunity for change.

What matters in the local adaptation of Western social innovation to China: deep core beliefs, institutional boundary conditions or managerial practices?

Article

Oct 2023

SAÚDE POSITIVA EM CASA

Article

Full-text available

Jan 2020

O projeto SPC – Saúde Positiva em Casa, é caraterizado por dois pilares: 1. Formação de cuidadores e assistentes pessoais; 2. Prestação de cuidados de saúde no domicílio a doentes crónicos e aos respetivos cuidadores informais, resultando na promoção da capacitação/literacia em cuidados de saúde e consequentemente na qualidade da saúde e bem-estar geral. Com o SPC pretende-se replicar e adaptar em Portugal o modelo Buurtzorg, implementado há mais de dez anos na Holanda. Este modelo baseia-se na prática da enfermagem comunitária. Buurtzorg, é ilustrativo duma nova estratégia de promoção da saúde positiva e do bem-estar geral dos indivíduos, comunidades, organizações, sociedades e do meio ambiente, estruturando-se no pilar das interconexões entre todos os contextos do doente, tais como a família; a vizinhança e a rede social de apoio

Scalability of digital psychological innovations for refugees: A comparative analysis in Egypt, Germany, and Sweden

Article

Full-text available

Jun 2023

E-mental health interventions may offer innovative means to increase access to psychological support and improve the mental health of refugees. However, there is limited knowledge about how these innovations can be scaled up and integrated sustainably into routine services. This study examined the scalability of a digital psychological intervention called Step-by-Step (SbS) for refugees in Egypt, Germany, and Sweden. We conducted semi-structured interviews (n = 88) with Syrian refugees, and experts in SbS or refugee’ mental health systems in the three countries. Data collection and analysis were guided by a system innovation perspective. Interviewees identified three contextual factors that influenced scalability of SbS in each country: increasing use of e-health, the COVID-19 pandemic, and political instability. Nine factors lay at the interface between the innovation and potential delivery systems, and these were categorised by culture (ways of thinking), structure (ways of organising), and practice (ways of doing). Factors related to culture included: perceived need and acceptability of the innovation. Acceptability was influenced by mental health stigma and awareness, digital trust, perceived novelty of self-help interventions, and attitudes towards non-specialist (e-helper) support. Factors related to structure included financing, regulations, accessibility, competencies of e-helpers, and quality control. Factors related to practice were barriers in the initial and continued engagement of end-users. Many actors with a potential stake in the integration of SbS across the three countries were identified, with nineteen stakeholders deemed most powerful. Several context-specific integration scenarios were developed, which need to be tested. We conclude that integrating novel e-mental health interventions for refugees into routine services will be a complex task due to the many interrelated factors and actors involved. Multi-stakeholder collaboration, including the involvement of end-users, will be essential.

Selvstyrende teams i hjemmeplejen: Nye forståelser af omsorg, borgere og omsorgsarbejdere

Article

Apr 2023

Maria Hjortsø Pedersen

Scalability of a task-sharing psychological intervention for refugees: A qualitative study in the Netherlands

Article

Full-text available

Nov 2022

Mental health systems across the world struggle to meet the needs of present and future populations. People affected by war and forced displacement, such as refugees, have especially high unmet psychological needs. Shifting tasks from mental health specialists to less specialised providers is increasingly opted as an innovative solution to overcome the mental health care gap. Yet little is known about how task-sharing interventions for refugees can be implemented on a larger scale and integrated in existing systems. In this article, we use a system innovation perspective to examine the factors influencing the potential for scaling up a task-sharing psychological intervention for refugees called ‘Problem Management Plus’ (PM+) in the Netherlands. Semi-structured interviews were conducted with individuals (n = 42) knowledgeable about PM+ and the Dutch mental health system for refugees. Findings suggest that the feasibility of wider implementation largely depends on whether barriers like stigma, attrition, fragmentation, competition, legal, and financial challenges can be overcome. Formalising the roles of new non-specialist workers will be important, including developing structures for their accreditation and supervision. There are various possibilities for institutional anchoring of the innovation: in asylum centres, formal health care, and communities. The integration scenarios identified in this study need to be tested, evaluated, refined, and reported in future implementation research.

Das Buurtzorg-Modell für die häusliche Pflege

Chapter

Sep 2022

Die häusliche Pflege in Deutschland wird teilweise durch Angehörige und teilweise durch ambulante Pflegedienste erbracht. Die Betroffenen wünschen sich dabei, dass eine adäquate Versorgung möglichst lange im häuslichen Umfeld gewährleistet wird. Aufgrund unzureichender personeller Ressourcen in der formellen Pflege aufgrund eines stetig zunehmenden Bedarfes könnten Ressourcen im Rahmen der Nachbarschaftshilfe unterstützend wirken. Durch die Vernetzung von informellen und formellen Netzwerken, die lokal als autonom arbeitende Teams agieren, könnte sich die häusliche Versorgung nachhaltig verbessern. Dieses integrierte Pflegemodell wird als Buurtzorg-Modell bezeichnet, stammt aus den Niederlanden und hat sich dort bereits fest etabliert. In Deutschland existieren derzeit mehrere Buurtzorg-Modellprojekte und der Ansatz wird mehr und mehr auf politischer Ebene und auf der Ebene der Selbstverwaltungspartner unterstützt und beworben. Für eine künftig flächendeckende Umsetzung müssten allerdings noch einige pflegepolitische Rahmenbedingungen verändert werden und in der Bevölkerung entsprechende Aufklärungsarbeit erfolgen.

Reasons for concealing disability in the labor market

Chapter

Full-text available

May 2021

Activation of people with disabilities in the labor market is an important issue for both social and economic reasons, but it is subject to a number of restrictions that sometimes result in such negative phenomena as disability hiding. The publication presents the results of a study in which researchers tried to find out the reasons for this situation based on semi-structured interviews with a group of over dozen people whose fate dictated the need of conceal their health restrictions by potential employers as well as at work. The research emerges a stigmatizing image of the Polish labor market as well as the imperfection of current support systems, which stigmatize and intensify discrimination processes in many places instead of counteracting them. Number of recommendations aimed at developing entrepreneurship for people with disabilities based on both interlocutors’ as well as and literature studies has been included.

Sehnsucht Agilität: Eine Klärung des Agilitätsbegriffs und eine Einführung in die Patterns of Integrated Organization

Article

Full-text available

Jun 2021

Unternehmen sehen sich mit erheblichem Veränderungsdruck und sozial komplexen Problemstellungen konfrontiert, für die Agilität als Lösung gehandelt wird. Damit verbinden sie die Hoffnung, einen wenig präzise definierten Wandel zu schaffen. Im aktuellen Agilitätsdiskurs zeichnet sich vorläufig weder im Arbeitsalltag noch in der Forschung ein Konsens über den Begriff ab. Dieser bietet eine Projektionsfläche, auf der unterschiedliche Weltsichten mit großer Wucht und wenig Reflexion aufeinanderprallen. Nach einer Analyse des Begriffs aus einer kognitiv-linguistischen Perspektive und der Untersuchung der Kernversprechen, die sich seit dem Beginn des Agilitätsdiskurses im ausgehenden 20. Jahrhundert mit dem Begriff verbinden, wird ein strukturierter Reflexionsprozess, die Patterns of Integrated Organization, vorgestellt. Diese dienen zur Klärung der auf den Begriff projizierten Sehnsucht und damit als Entscheidungshilfe für eine Organisationsgestaltung im Einklang mit bewusst verhandelten Standpunkten.

Dismantling the Blueprint: Buurtzorg in English child protection social work

Article

Feb 2021
Eur J Soc Work

November 2019 saw the release of A Blueprint for Children's Social Care (hereafter the Blueprint) in England. The Blueprint proposes introducing the Buurtzorg model of community nursing into the child protection social work in England, and received widespread interest and publicity. Buurtzorg is a Dutch community nursing agency that is based on a specific model of small self-managing and non-hierarchal teams. The authors of the Blueprint suggest that rapid and large-scale introduction of Buurtzorg into child protection social work would overcome many of the longstanding issues facing the profession in England. However, there are serious limitations to the suggestions outlined in the Blueprint and the Buurtzorg model does not translate well to child protection social work in England. Drawing on the work of Mark Fisher, this article examines the Blueprint under three core themes: consent and consensus, links with other neoliberal projects and failing forward. Ultimately, it is shown that the Blueprint can be considered part of a wider project of implementing neoliberal policies and market solutions to children's social care in England, a process that is increasingly being led by large, profit-driven global consultancy firms.

Chapter 8: Gunnar Myrdal on Social Vulnerability

Chapter

Jan 2021

Irene van Staveren

This chapter discusses the work of Gunnar Myrdal, the Swedish economist who was as one of the founders of the Swedish welfare state. His work centres around discrimination and resilience. His insights are important for understanding why disadvantaged groups show the least resilience during a crisis, but also why well-meaning government policies may make matters worse. For that reason, he sees not only a solution in the state, but also within households, through labour unions and more political space for disadvantaged groups to express their voices. His theory of cumulative causation reflects insights from systems theory and emphasizes feedback effects of discrimination in labour markets, education and informal institutions (such as social norms). The remedy is, according to Myrdal, resilient institutions at the aggregate level of the economy instead of micro-level policies.

Internal flexibility in health-care organizations: a value-laden perspective on sustainability

Article

Nov 2020
Int J Organ Anal

Pradeep Kumar

Purpose This study aims to identify the constituents of internal flexibility in health-care organizations for achieving sustainability. The study incorporates resources-based theory and resource-dependence theory to illustrate how health-care organizations exhibit internal flexibility to redress environmental uncertainties and maximize organizational responsiveness. Design/methodology/approach This paper conducts a case study in a health-care organization to explore how health-care organizations acquire several resources for attaining internal flexibility. A survey of health-care professionals was conducted to assess the relationships using partial least squares-structural equation modeling. Findings In the present study, the dimensions of internal flexibility in health-care organizations are identified. This study also established internal flexibility as a higher-order factor and explained its underlying aspects as a value-laden perspective on sustainability. Research limitations/implications The study was conducted in the public health-care context in India. The framework needs to be tested in another context. The sample size for the study was limited to health-care experts, which could be extended to include the customer’s perspective. Originality/value The study contributes to the body of knowledge by identifying the specific dimensions of internal flexibility and explains as a higher-order factor. It enhances the understanding of sustainability from a flexibility perspective of the firm.

Decentral Energy production and integration in the Stavanger region - A techno-economic case study of Stavangerregionen Havns and Risavikas solar production potential and its contribution to the local energy challenges within the Elnett21 project

Thesis

Full-text available

Aug 2020

Rouven Uzelmaier

This thesis explores the solar production potential of Stavangerregionen Havn and Risavika and its possible contribution to the local energy challenges within the Elnett21 projects, that arises with the transport electrification strategy from the Norwegian government. The aim of this study is first to show the solar electricity generation potential for the given buildings and then investigate an economic long-term performance of those projects. Furthermore, will be explored how the integration of local produced electricity can be supported by battery storage systems. The thesis uses a Mixed-Method approach which gives the option to explore qualitatively the possibilists and challenges of the concept of system decentralization, decentral solar production and battery storage. Additionally, is through the utilisation of the K2 and PVsyst software the simulated electricity generation potential explored on which bases the quantitative analysis and economic evaluation is executed. Our analysis shows that Stavangerregionen Havn and Risavika have great electricity production potential which could be utilised. Furthermore, gives the economic long-term evaluation a positive output for the Ferry-Terminal as main case study object. We concluded that through the development of local generated solar electricity and the utilisation of battery storage significant contribution towards Elnett21 and the challenges are possible. Dependent on the size of future solar production and battery storage capacity can the contribution be bigger or smaller.

Green service production in healthcare and role of value chain flexibility

Article

Jul 2020
Int J Prod Perform Manag

Pradeep Kumar

Purpose This paper aims to understand the specific role of value chain flexibility (VCF) in the strategies of green service production (GSP) in healthcare. The study explores the key dimensions of VCF and their linkages with the current GSP strategies in healthcare firms. Design/methodology/approach The study uses an exploratory case study with three representative national-level healthcare firms in India. A multiple case study methodology was utilized to explore the relationships between GSP and VCF. Findings The findings of the study suggest that several strategies for GSP require the support of multiple dimensions of VCF. More importantly, the role of each dimension of VCF depends upon the innovativeness of green service design, green procurement and green service practices. Research limitations/implications The study was conducted in the emerging healthcare market of India. Thus, the generalizability of the framework needs to be tested in another context. The study reports the employee's perception, and the patients’ (customers) views were not included. Originality/value The study is a first step to understand the theoretical perspectives of the relationships between GSP and VCF by exploring the underlying concepts. Furthermore, the study explicates the dynamics of their interplay in a systematic way and contributes to a framework of GSP and VCF in the healthcare context.

Envisioning the future of health systems: exploratory insights from European Countries

Article

Jun 2020
FUTURES

European countries strive to provide people with a timely and appropriate access to care. Different models and approaches are implemented for this purpose. Whilst scholars have proposed various taxonomies to point out the peculiarities of health system types, little is known about patients’ satisfaction with the health services provided by such systems. This prevents a vision of the future of health care. The article intends to fill this gap through an empirical analysis of secondary data collected from the Eurofound’s database. Adhering to the taxonomy developed by Reibling and colleagues (2019), we investigated the performances of health systems types in terms of: 1) perceived quality of health services; 2) affordability of health care; 3) satisfaction with primary care; 4) satisfaction with secondary care; and 5) equity in the provision of care. Findings suggested that countries characterized by a thin access regulation and imposing a cost-sharing mechanism outperformed other health system types. Countries adopting a national health service scheme implying a strict access regulation and limited cost sharing were considered to be unfair. Health systems’ economic and social sustainability relies on the policy makers’ ability to stress the strengths of existing health system types, overcoming their weaknesses in terms of equitable and timely access to care. The future of health care will benefit from a contamination of existing health system types, which may lead to hybrid models able to merge fairness with financial sustainability.

Buurtzorg -an innovative model for caring elderly at home

Article

Full-text available

Feb 2017

The Dutch home care provider Buurtzorg Nederland has attracted widespread interest for its innovative approach for caring elderly at home. Buurtzorg – meaning ‘neighbourhood care’ – empowers nurses to help their home care clients retain independence and autonomy. Buurzorg has earned high level of client and employee satisfaction and appears to provide high-quality home care at lower cost than other organizations. The model is spread worldwide, including Sweden, Japan, and United States. Currently this model will be tested and evaluated in Finland.

Humanising healthcare

Article

Full-text available

Dec 2016
Br Med J

Situated Novelty A study on healthcare innovation and its governance

Book

Full-text available

Sep 2016

Maarten Janssen

see: www.situatednovelty.com for a full text version of the book. Healthcare innovation is a hot topic among policy makers, researchers and professionals, attracted to the longstanding public debate by high expectations of the potential benefits. Putting innovation into practice, however, is often more complex than expected, and the results are sometimes even disappointing. This book delivers in-depth insights into healthcare innovation processes, based on the lessons learned in five case studies of innovation practices. The book introduces a multidisciplinary approach to the governance of healthcare innovation: ‘Situated Novelty’. In the Situated Novelty approach, innovation is not just about novelty. It emerges from contextualized, interactional and time-dependent processes and has different meanings in practice. Situated Novelty emphasizes the importance of never-ending processes that construct innovations and their value. In this view, the governance of innovation consist of attempts made to influence emergent, temporary and fluid processes of change. Situated Novelty has major implications for innovation practice, management and policy as it has the potential to change current attitudes to innovation and opens up new possibilities to act. Overall, the Situated Novelty approach argues for deeper practical and theoretical reflection on the essence and meaning of innovation. This book will interest all concerned with the management, organization and governance of innovation in healthcare practice and beyond.

Experimenting in the city. Unpacking notions of experimentation for sustainability

Chapter

Full-text available

May 2016

This chapter articulates a comprehensive definition of the notion of ‘experimentation’ in the context of urban sustainability transitions. Highlighting a number of key dimensions, we argue that experiments can be analysed according to the degree to which they are (1) inclusive, (2) systemic, (3) practice-based, (4) challenge-led and (5) adaptive in the face of uncertainty and ambiguity in fostering socio-technical change. We point out a number of urban governance challenges related to coordination, commitment and negotiation, and we highlight a number of promising avenues for future research on experimenting in the city.

Towards a better understanding of transitions and their governance, A systemic and reflexive approach, as Part II

Article

Full-text available

Jan 2010

The learning infrastructure of self-managing work teams

Article

Full-text available

Jan 2003

S. Tjepkema

Transition management: reflexive governance of societal complexity through searching, learning and experimenting

Article

Full-text available

Jan 2008

Our society faces a number of persistent problems whose symptoms are becoming more and more apparent. Persistent problems are complex because they are: deeply embedded in our societal structures; uncertain because of the hardly reducible structural uncertainty they include; difficult to manage with a variety of actors with diverse interests involved; and hard to grasp, in the sense that they are difficult to interpret and ill-structured (Dirven et al. 2002). Persistent problems are the superlative form of what Rittel and Webber (1973) refer to as ‘wicked’ problems. Examples of persistent problems are: the energy problem with anthropogenic climate change as manifestation; the agricultural problem with symptoms such as animal diseases such as bird flu, mad cow disease and foot-and-mouth disease; the water problem illustrated by major floods and periods of drought; and the mobility problem with traffic congestion and air pollution due to increased mobility. Persistent problems could generally be considered to be symptoms of an unsustainable society. These persistent problems cannot be solved using only current policies (SER 2001). Persistent problems are related to the system failures that have crept into our societal systems which, contrary to market failures, cannot be corrected by the market or current policies. Existing policies are necessary but not sufficient; much more is needed. In order to combat system failures a restructuring of our societal systems is required: transitions. A transition is a structural change in a societal (sub)system that is the result of a co-evolution of economic, cultural, technological, ecological and institutional developments at different scale levels (Rotmans et al. 2000). Transitions cannot be steered in command and control terms, because they are too complex phenomena with many uncertainties and surprises. However, transitions can be influenced and guided, in terms of influencing the speed and direction of these processes. The latter we call transition management, which will be described below.

Transition Experiments: Exploring societal changes towards sustainability

Thesis

Full-text available

Sep 2010

Suzanne Van den Bosch

This PhD thesis presents the outcome of exploratory research on how transition experiments can be used as instruments to further sustainable development. A transition experiment is a specific type of innovation project that is aimed at exploring radically new ways to meet societal needs, such as the need for energy, mobility and health care. Transition experiments are a key instrument of the governance approach Transition Management (TM), which has recently been developed and applied to influence and direct transitions towards sustainability. This book presents a conceptual framework for analysing and managing transition experiments and their potential contribution to sustainability transitions. Central concepts in this framework are the mechanisms deepening (learning in a specific context), broadening (linking and repeating in different contexts) and scaling-up (embedding in established ways of thinking, doing and organising). The framework was developed in interaction with practitioners in three Dutch sustainability programmes: Learning for Sustainable Development, Transumo (TRANsition to SUstainable MObility) and the Transition Programme in Long-term Care. The practice-oriented concepts and examples that are described in this book could provide researchers, policy makers, programme managers and project leaders with a new way of looking at the role of innovation projects in transitions to sustainable development.

Deepening, Broadening and Scaling up: a Framework for Steering Transition Experiments.

Book

Full-text available

Nov 2008

This essay presents a conceptual framework for analyzing and influencing the contribution of small-scale experiments to transitions towards a more sustainable society. This framework is aimed at providing academics and practitioners with a theoretical and practice oriented perspective to both understand and ‘steer’ the contribution of experiments to transitions. The central instrument in this framework are ‘transition experiments’, which provide an alternative approach to classical innovation projects that are aimed at realizing short-term solutions. A transition experiment is an innovation project with a societal challenge as a starting point for learning aimed at contributing to a transition.

The usefulness of evolutionary models for explaining innovation. The case of the Netherlands in the nineteenth century

Article

Full-text available

Apr 1998

Johan Schot

Why do nations and industrial sectors cease to be pioneers? This question is discussed for the case of The Netherlands. Why was innovation in The Netherlands in the nineteenth century virtually limited to elaborating on developments in other countries whereas before it had been a technological paradise? It is argued here that no single reason can account for this loss of technological leadership. A complex of — often mutually reinforcing — factors was at work, some more important than others depending on the sector. The core of the explanation is that the Dutch had developed their own technological regime which was perfected before the nineteenth century. When a new regime emerged elsewhere it was difficult for the Dutch to adjust because of a complex set of barriers embedded in the existing technological regime. The inclination was to revitalise the old merchant capitalist regime and with success — albeit limited in the long run —, as some of the cases in the article show. This conclusion leads to a further question: How do regime shifts occur? Drawing on an evolutionary model, it is argued that new technologies emerge in technological niches, which after a process of branching can lead to a regime shift. Such a shift happens when successful niche formation coincides with a number of favourable external developments. Successful niche formation depends on the articulation of expectations, the coupling of new markets and new technologies, the development of new networks and the emergence of new competences.

Transitions and strategic niche management: Towards a competence kit for practitioners

Article

Full-text available

May 2010

Structural problems in modern societies, such as climate change and congestion problems, require 'transitions' towards a more sustainable fulfilment of social needs. Recent research shows that experimenting in niches is crucial for learning about social challenges and stimulating transitions. Through a series of 'transition experiments' in different niches, social innovations can be improved and eventually replace dominant practice. This article reviews the literature on transitions and strategic niche management and argues that it has a strong analytical core, but less effort has been made to develop a managerial perspective. The authors aim to contribute to such perspective by developing a 'competence kit': a learning module that provides practitioners (e.g., policy makers, companies, intermediary organisations and NGO's) that are involved in transition experiments with an analytical framework, guidelines and tools and recognisable examples. The results from the first workshop with practitioners to explore potential applications of the competence kit are promising.

Learning for Sustainability Transition through Bounded Socio-technical Experiments in Personal Mobility

Article

Full-text available

Sep 2003

A bounded socio-technical experiment (BSTE) attempts to introduce a new technology, service, or a social arrangement on a small scale. Many such experiments in personal mobility are ongoing worldwide. They are carried out by coalitions of diverse actors, and are driven by long term and large scale visions of advancing society’s sustainability agenda. This paper focuses on the processes of higher-order learning that occur through BSTEs. Based on the conceptual frameworks from theories of organizational learning, policy-oriented learning, and diffusion of innovation, we identify two types of learning: the first type occurs among the participants in the experiment and their immediate professional networks; the second type occurs in the society at large. Both types play a key role in the societal transition towards sustainable mobility systems. Two case studies, in which the Design for Sustainability Group at Technical University of Delft has participated, provide empirical data for the analysis. One case consists of development of a three-wheeled bike-plus vehicle (Mitka); the second case seeks to solve mobility problems on the Dutch island of Texel. We find that higher order learning of the first type occurs among the BSTE participants and beyond. Learning can be facilitated by deployment of structured visioning exercises, by diffusion of ideas among related BSTEs, by innovative couplings of problems and solutions, and by creating links among related experiments. Government agencies, universities and other intellectual entrepreneurs have key roles to play in making that happen. The cases provide much less insights about the second type of learning. Research on the latter is necessary.

Societal embedding and product creation management

Article

Full-text available

Jun 1997

Societal embedding of new products – that is, their integration in relevant industries and markets, their admissibility with regard to regulation and standards, and their acceptance by the public – is a challenge. A management approach is developed based on our case studies in the biotechnology sector and on recent innovation literature. Tools are presented to map internal and external alignments. Learning processes, in interaction with societal actors, overcome the dilemmas or at least make them manageable.

Transitions to Sustainable Development: New Directions in the Study of Long Term Transformative Change

Book

Full-text available

May 2010

Over the past few decades, there has been a growing concern about the social and environmental risks which have come along with the progress achieved through a variety of mutually intertwined modernization processes. In recent years these concerns are transformed into a widely-shared sense of urgency, partly due to events such as the various pandemics threatening livestock, and increasing awareness of the risks and realities of climate change, and the energy and food crises. This sense of urgency includes an awareness that our entire social system is in need of fundamental transformation. But like the earlier transition between the 1750's and 1890's from a pre-modern to a modern industrial society, this second transition is also a contested one. Sustainable development is only one of many options. This book addresses the issue on how to understand the dynamics and governance of the second transition dynamics in order to ensure sustainable development. It will be necessary reading for students and scholars with an interest in sustainable development and long-term transformative change.

Introduction of new technology: Making use of recent insights from sociology and economics of technology

Article

Full-text available

Jan 1995

Arie Rip

Retrospective studies have shown the non-linear and situated character of technological developments; the importance of articulation of demand and of acceptability, and how these are part of large socio-technical transformations; and how technical nd socio-technical alogment activities occur and are consciously shaped by ‘macro-actors’. These insights are transformed into thirteen suggestions for successful introduction of new technology.

HOW INNOVATION IMPACTS SOCIETY Patterns and mechanisms through which innovation projects contribute to transitions

Conference Paper

Full-text available

Mar 2006

Persistent problems in society require structural societal transformation. In recent research the concept of transitions is developed that gives a new perspective on these urgent transformation processes. Innovation projects play an important role in transition management as part of on over-all innovation strategy and portfolio. These innovation projects or 'transition experiments' are characterized by a focus on learning, high risks and uncertainty and involvement of multiple actors and networks. This paper aims to make a contribution to the theory on the relation between strategic innovation projects and structural societal change or transitions; a central question is "Through which mechanisms and patterns can innovation projects contribute to structural societal change?". Departing from complex adaptive systems theory, a literature study is conducted incorporating insights from innovation studies, learning and transitions. This leads to the development of a heuristic of patterns and mechanisms through which transition experiments might shape the wider societal system. Central are three mechanisms, deepening, broadening and scaling up that explain the pattern of broad scale societal change emerging from small-scale innovations.

Governing Transitions in the Sustainability of Everyday Life

Article

Full-text available

May 2010
RES POLICY

The literature on sociotechnical transitions and their governance tends to concentrate on the introduction of new technologies and systems of supply. In this paper we seek to extend the scope of debate, introducing aspects of practice theory as a means of also conceptualising the dynamics of demand. Rather than treating ‘human need’ or ‘societal functions’ as given, we consider how variously sustainable practices come into existence, how they disappear and how interventions of different forms may be implicated in these dynamics. We use the two cases of daily showering and the congestion charging scheme in London to consider the distinctive challenges of understanding transitions in practice and of governing these so as to engender more sustainable ways of life.

The practice of transition management: Examples and lessons from four distinct cases

Article

Full-text available

Apr 2010
FUTURES

In this article we present four different cases of transition management in which we were involved over the past 10 years. Transition management was developed in the course of this period in theoretical and practical sense, mainly in the Netherlands, as novel mode of governance for sustainable development. The theoretical debate about transition management is being increasingly published, but so far only few empirical examples were. In this article we present four cases that combined give a representative illustration of both the advantages and the difficulties of actually trying to manage transitions. The article ends by drawing lessons and formulating research questions for the future.

Transition Management: New Mode of Governance for Sustainable Development

Article

Full-text available

Jan 2007

Derk Loorbach

Proefschrift Erasmus Universiteit. Lit. opg.: p. 301-314. - Met een samenvatting in het Engels.

Niches in Evolutionary Theories of Technical Change: A Critical Survey of the Literature

Article

Full-text available

Feb 2007
J EVOL ECON

In this article, the use of the niche concept for explaining radical technical change is explored. Contributions of various strands of literatures are elaborated and systematized in a taxonomy. Radical change or technological discontinuity is defined as the establishment of a new sociotechnical regime. Sociotechnical regimes carry and store rules for how to produce, use and regulate specific technologies. They perform the task of genes and define the boundary between technological species. It is proposed that radical change is generated by four different evolutionary mechanisms and patterns: natural selection, punctuated equilibrium, market niche selection, and technological niche selection. In each pattern, a different type of niche is implicated in the change process. The difference between niches results from differentiating between two dimensions: (1) whether niches are internal or external to the prevailing sociotechnical regime; (2) whether rules for design and use of a specific technology are stable or unstable within the niche.

The Challenge of Complexity in Health Care

Article

Full-text available

Oct 2001

The Slow Pace of Rapid Technological Change: Gradualism and Punctuation in Technological Change

Article

Full-text available

Feb 1998
IND CORP CHANGE

Daniel A. Levinthal

Discussions of technological change have offered sharply contrasting perspectives of technological change as gradual or incremental and the image of technological change as being rapid, even discontinuous. These alternative perspectives are bridged using the punctuated equilibrium framework of evolutionary biology. Using this framework, it is argued that the critical event is not a transformation of the technology, but speciation--the application of existing technology to a new domain of application. As a result of the distinct selection criteria and the degree of resource abundance in the new domain, a new technological form may emerge. The new technological form may be able to penetrate other niches and, in particular, may precipitate a process of 'creative destruction' and out-compete prior technologies. This framework is applied to an historical study of wireless communication from the early experimental efforts of Hertz to the modern development of wireless telephony. Copyright 1998 by Oxford University Press.

The making of a Transition Program in the Dutch care sector 1

Chapter

Mar 2017

Diffusion of Innovations

Book

Jan 1983

E. M. Rogers

The dynamics of socio-technical transitions: A socio-technical perspective

Article

Jan 2010

Scale dynamics of grassroots innovations through parallel pathways of transformative change

Article

Aug 2016
ECOL ECON

Transitions to sustainable development-new directions in the study of long term transformative change

Article

Jan 2012

P. Wachter

Managing Experiments for Transition: Examples of Societal Embedding in Energy and Health Care Sectors

Article

Nov 2004

Organizational Innovation by Integrating Simplification

Book

Dec 2014

Sharda Nandram

Explains a client-focus approach to be easily applied in different contexts Provides evidence-based theory and applicable model Provides a detailed description of the case to inspire a context specific application This book presents the theory of integrating implification and it provides a profound evidence based study of Buurtzorg Nederland. The case itself, forming the building block of the theory, has received tremendous interest in the Netherlands and abroad. This is the first international book on Buurtzorg Nederland and the first one departing from a management multidisciplinary perspective. The book demonstrates theory building by using the Grounded Theory Methodology as a way to contribute to management theory. Integrating simplification gives room for context specific implementation of organizational innovation to different industries. One of the most talked about and innovative cases in community care: the successful and award winning practice of Buurtzorg. There is only one simple focus: the wellbeing of the client. Prof. Dr. Mathieu Weggeman, the Netherlands All grounded theories are asymptotic, that is as close to perfection as possible. Sharda has come very close to achieving a perfect Grounded Theory. Read well and enjoy the conceptual level and integration of concepts! Barney G. Glaser, PhD, Hon. PhD, USA Integrating Simplification Theory shows in a lucid and convincing way, how constructing reality based on different sources and processes of knowledge results in new organization creation. Prof. Ikujiro Nonaka, Japan Sharda has seamlessly combined the Eastern and Western philosophies to explain human principles of organizing the reality around us. The book has truly brought out the "art of management". Dr. Madhumita Chatterji, India The humanistic leadership of Buurtzorg demonstrates the Yoga philosophy which transcends the duality of matter and spirit as well as the duality of self and others, leading to radical simplicity. Sharda has provided a fascinating analysis of a fascinating case. Prof. Laszlo Zsolnai, Hungary Content Level » Professional/practitioner Keywords » Buurtzorg Nederland - Craftsmanship - Entrepreneurial space - Healthcare management - Organizational innovation - Self-managed teams Related subjects » Innovation - Technology Management - Organization - Human Resource Management - Public Health - Social Sciences TABLE OF CONTENTS Towards a New Way of Organizing.- Buurtzorg Nederland: Start-up Process and Organizational Design.- Theory of Integrating Simplification.- Attuning to Clients.- Subtle Craftsmanship in Communities.- Intrapreneurial Team Freedom.- Pragmatic Will with ICT.- Leading Higher Purpose.- Scientific Contribution of IST in the Domain of Organizational Innovation.- Implications and Discussion.- Reflections and Conclusion. http://www.springer.com/business+%26+management/organization/book/978-3-319-11724-9

Health care reform and reform for health: Creating a health system for communities in the 21st century

Article

Jun 1999
FUTURES

If we are to improve the health of the population and reduce the inequalities in health that plague our communities and our planet, we will have to give greater attention to the determinants of health. The reform of the health care system, necessary though it is, will never be sufficient; we need to reform our whole society and in particular to focus on human rather than economic development. At the community level we need to create healthy communities that are “health-creating systems” of environmental, social and human development, as well as health care systems that focus first on improving and maintaining health. Such a “bottom-down” health care system would see the hospital become once again the place of last resort (but still a potentially important partner in creating healthier communities) and would focus instead on how to provide health promotion and health care from the household level up.

Tracing discursive space: Agency and change in sustainability transitions

Article

Jun 2014
TECHNOL FORECAST SOC

Udo Pesch

This article argues that a lack of a consistent agency-based approach in theory on sustainability transitions makes it difficult to describe processes of change. To overcome this problem, elements from transition theory will be rearticulated in terms of ‘discursive fields’, which are the bodies of meanings with which actors engage in social action. With that an agency-based conceptual framework is developed with which processes of change related to sustainability transitions can be researched. Discursive fields are subjected to a different degree of ‘fixation’—some discursive fields are more susceptible to change than others. The notion of discursive fixation helps us to develop new insights about the some of the elementary elements of sustainability transitions, such as the establishment of a so-called socio-technological niche, as well as the scaling up of the outcomes of such a niche. Moreover, the approach developed will be used to explore how individual agents can contribute to change processes. These insights give rise to an array of new empirical research in relation to sustainability transitions.

Socio-technical regimes and sustainability transitions Insights from political ecology

Article

Jun 2012

Sustainability is increasingly becoming a core focus of geography, linking subfields such as urban, economic, and political ecology, yet strategies for achieving this goal remain illusive. Socio-technical transition theorists have made important contributions to our knowledge of the challenges and possibilities for achieving more sustainable societies, but this body of work generally lacks consideration of the influences of geography and power relations as forces shaping sustainability initiatives in practice. This paper assesses the significance for geographers interested in understanding the space, time, and scalar characteristics of sustainable development of one major strand of socio-technical transition theory, the multi-level perspective on socio-technical regime transitions. We describe the socio-technical transition approach, identify four major limitations facing it, show how insights from geographers – particularly political ecologists – can help address these challenges, and briefly examine a case study (GMO and food production) showing how a refined transition framework can improve our understanding of the social, political, and spatial dynamics that shape the prospects for more just and environmentally sustainable forms of development.

Zelfsturende teams in de praktijk

Article

Aug 2012

Theories of practices: Agency, technology, and culture : Exploring the relevance of practice theories for the governance of sustainable consumption practices in the new world-order

Article

Aug 2011
GLOBAL ENVIRON CHANG

Gert Spaargaren

Within the environmental social sciences, theories of practices are used by an increasing number of authors to analyze the greening of consumption in the new, global order of reflexive modernity. The use of practices as key methodological units for research and governance is suggested as a way to avoid the pitfalls of the individualist and systemic paradigms that dominated the field of sustainable consumption studies for some decades. With the help of practice theory, environmental governance can be renewed in three particular ways: First, the role and responsibilities (not) to be assigned to individual citizen-consumers in environmental change can be specified. Secondly, objects, technologies and infrastructures can be recognized for their crucial contribution to climate governance without lapsing into technological determinism. Third, the cultural framing of sustainability can be enriched by looking into the forms of excitement generated in shared practices of sustainable consumption. We conclude by discussing the need to investigate the globalization of practices from a post-national perspective in both science and policy.

Anchoring of innovations: Assessing Dutch efforts to harvest energy from glasshouses

Article

Dec 2012

Local and global dynamics in technological development: A socio-cognitive perspective on knowledge flows and lessons from reinforced concrete

Article

May 2006

Although knowledge flows are a popular concept, the underlying dynamics are not well understood. This article develops a perspective that conceptualises the social and cognitive activities that make knowledge flows possible. Dynamics involve interactions between local and global levels, and dedicated aggregation activities by intermediary actors. An idealtypical four-phased pattern is developed to understand the creation of global knowledge. The socio-cognitive perspective is illustrated with a historical case study, the emergence of reinforced concrete (1850–1940). The concluding section formulates policy implications for nurturing the emergence of radically new technologies. Copyright , Beech Tree Publishing.

On the Role of Outsiders in Technical Development

Article

Sep 2000

Ibo van de Poel

In this paper, it is argued that outsiders play an important role in the dynamics of technical change and that, for this reason, outsider involvement is also an important entry if one wants to 'improve' or democratize technical development. Outsiders are defined as people not involved in technical development and not sharing the rules that guide the design and development of a technology. The totality of these rules makes up the technological regime of a technology. Technological regimes are characterized by certain trajectories of technical development. The focus in this paper is on outsiders who may trigger (radical) technical change that transform current technological regimes. Three different types of such outsiders are distinguished and their role in technical development is discussed: professional scientists and engineers, outsider firms and societal pressure groups.

Regime Shifts to Sustainability Through Processes of Niche Formation: The Approach of Strategic Niche Management

Article

Jun 1998

The unsustainability of the present trajctories of technical change in sectors such as transport and agriculture is widely recognized. It is far from clear, however, how a transition to more sustainable modes of development may be achieved. Sustainable technologies that fulful important user requirements in terms of performance and price are most often not available on the market. Ideas of what might be more sustainable technologies exist, but the long development times, uncertainty about market demand and social gains, and the need for change at different levels in organization, technology, infastructure and the wider social and institutional context-provide a great barrier. This raises the question of how the potential of more sustainable technologies and modes of development may be exploited. In this article we describe how technical change is locked into dominant technological regimes, and present a perspective, called strategic niche management, on how to expedite a transition into a new regime. The perspective consists of the creation and/or management of nichesfor promising technologies.

Public health care services in the advanced welfare state Observations from the Swedish futures study care in society

Article

Aug 1985
FUTURES

Mårten Lagergren

In 1978 the Swedish Secretariat for Future Studies—a government advisory body for long-term issues of broad societal significance—began its project “Care in Society”. The final project report was published in May 1982. The original purpose of the project was to study how conditions in society affect needs for care in different forms and how these needs are met—informally or through formal institutions. More broadly, the study came to be a general assessment of the welfare state and its growing problems. This article examines findings and proposals from the Swedish report.

Sustainability transitions in the making: A closer look at actors, strategies and resources

Article

Jul 2012
TECHNOL FORECAST SOC

Attention is drawn to the dynamic interaction between what different kinds of actors do and what can be observed at the system level. It aims to provide a closer look at how strategies, resources and capabilities of individuals, firms and other organizations impact the overall system and trigger transformation processes, and how these changes at the system level feed-back into the observed strategies at the actor level. This is important, not in the least because the particularity of sustainability transitions is that they are often purposefully initiated (or supported) and directed in the sense that long-term future visions are supposed to guide these transitions.While guidance of distributed actors is essential, it has been acknowledged that future visions as well as the means to achieve these visions are contested, with different actor groups claiming and advocating different interests. As we improve our understanding of the dynamic interplay of different actors involved in innovation and transition processes, we will be able to untangle some of the complexities of transitions unfolding at the system level. To contribute to this general line of reasoning, our special issue calls particular attention to the strategies and resources of actors in sustainability transitions. In this introduction we will concentrate on the following questions knowing that these can only shed light on some of the complex issues at hand: – What strategies do actors adopt to shape sustainability transitions and what resources do they mobilize and deploy in the realization of these strategies? – What kinds of different actors play a role in these transformation processes and how can and do they align their strategies (and resources) to achieve common goals?

Sustainability transitions: An emerging field of research and its prospects

Article

Jul 2012
RES POLICY

Sustainability oriented innovation and technology studies have received increasing attention over the past 10-15 years. In particular, a new field dealing with "sustainability transitions" has gained ground and reached an output of 60-100 academic papers per year. In this article, we aim to identify the intellectual contours of this emerging field by conducting a review of basic conceptual frameworks, together with bibliographical analysis of 540 journal articles in the field. It is against this background that we position the six papers assembled in a special section in Research Policy. These papers pave the way for new conceptual developments and serve as stepping-stones in the maturation of sustainability transition studies, by linking with the scholarly literatures of management studies, sociology, policy studies, economic geography, and modeling.

What is protective space? Reconsidering niches in transitions to sustainability

Article

Jul 2012
RES POLICY

Non-linearity and Expectations in Niche-Development Trajectories: Ups and Downs in Dutch Biogas Development (1973–2003)

Article

Jul 2006

Non-linearity and changes in the direction of technological trajectories, are related to changes in cognitive rules and expectations that guide technical search and development activities. To explain such changes, the article uses the literature on niche development, which highlights interactions between learning processes, network building and expectations. A long-term case study on Dutch biogas development illustrates how these interactions explain non-linearity, but the case study also shows the importance of external regime dynamics. It is concluded that non-linearity and changes in niche expectations are related to both internal learning processes and external developments.

More Evolution Than Revolution: Transition Management in Public Policy

Article

Feb 2001
Foresight

Transitions are transformation processes in which society changes in a fundamental way over a generation or more. Although the goals of a transition are ultimately chosen by society, governments can play a role in bringing about structural change in a stepwise manner. Their management involves sensitivity to existing dynamics and regular adjustment of goals to overcome the conflict between long-term ambition and short-term concerns. This article uses the example of a transition to a low emission energy supply in the Netherlands to argue that transition management provides a basis for coherence and consistency in public policy and can be the spur to sustainable development.

Caring for Healthcare Entrepreneurs - Towards successful entrepreneurial strategies for sustainable innovations in Dutch healthcare

Article

Sep 2013
TECHNOL FORECAST SOC

The sustainability of current healthcare systems is threatened by several societal developments, including an aging population, an increase of unmet medical needs and rising healthcare costs. A transition is needed in rder to meet these threats and to achieve a proper balance between the demand for care and the capacity to supply it. Entrepreneurs play a crucial role in developing the required sustainable innovations for this structural change. They are able to develop innovations in close interaction within the healthcare context. This paper studies entrepreneurial strategies for the successful development of sustainable innovations in Dutch healthcare. Data comes from semistructured interviews with healthcare entrepreneurs. Results show that entrepreneurs experience the interaction with the healthcare systemcontext in various ways and act accordingly. Four types of sustainable healthcare entrepreneurs could be identified: isolated, innovative, evolutionary and revolutionary. These entrepreneurial types differ in terms of their beliefs as to whether and how individual entrepreneurs can contribute to achieving structural change in healthcare.

The scaling-up of Neighbourhood Care: From experiment towards a transformative movement in healthcare

Abstract

No full-text available