title: Curing a meagre health care system by lean methods--translating 'chains of care' in the Swedish health care sector.
abstract: The purpose of this article is to discuss what happens when work embedded in a 'meagre' organizational context is changed by lean production-related methods. The article is based on studies of seven lean production-inspired projects in the Swedish health care sector, a sector already poor due to organizational slack. The projects were directed to develop 'health care chains', an organizational concept regarded as a way to rationalize health care organizations as well as to develop them, i.e. increase productivity, quality from a customer perspective and quality of working conditions. The article analyses the projects from an interpretative perspective and discusses how modem management models with ambitions to concurrently rationalize and develop organizations--e.g. lean production and health care chains--are used in a 'meagre' organizational field. As an outcome, a model is presented that explores what is beyond simple imitations and unique translations of ideas when a new concept is implemented in local organizations.
authors.affiliation: Gothenburg Research Institute, School of Economics and Commercial Law, Göteborg University, SE 405 30 Göteborg, Sweden. bjorn.tragardh@handels.gu.se
authors.forename: Björn
authors.initials: B
authors.lastname: Trägårdh
authors.forename: Kajsa
authors.initials: K
authors.lastname: Lindberg
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D017146:Models, Organizational; D013222:State Medicine / Q000191:economics / Q000458:organization & administration*; D013548:Sweden