Exploring Managerial Job Demands and Resources in Transition to Distance Management: A Qualitative Danish Case Study.

Organizations worldwide have shifted to working from home, requiring managers to engage in distance management using information and communication technologies (ICT). Studies show that managers experience high job demands and inadequate guidance during COVID-19; therefore, the transition to distance management raises questions about the increase in managerial job demands and the impact on managers' well-being. This study aims to explore first-line managers' perceptions of job demands and available resources during the first year of the pandemic and understand the implications for first-line managers' well-being. First-line managers face complex and conflicting demands, making them more challenged in their management task than other management levels. We used the job demands-resources model in this qualitative, longitudinal empirical study. The study draws on 49 semi-structured interviews with seven first-line managers from a large pharmaceutical company in Denmark, whom we followed throughout the first year of the COVID-19 pandemic, from May 2020 to May 2021. Our findings suggest that the first-line managers perceived increased emotional and practical demands. While the managers appreciated the initial guidance provided by the organization, they perceived the organizational support as outdated and superficial. As a result, to cope with the uncertainty caused by the pandemic and the shift to distance management, the managers relied on work engagement enablers such as social support. Even though the COVID-19 pandemic portrays unique circumstances in transitioning to distance management that require further exploration outside the COVID-19 context, the insights from this study can assist organizations in developing awareness about transitions to better support first-line management to embrace changes in the future.

How to design, implement and evaluate organizational interventions for maximum impact: the Sigtuna Principles.

Research on organizational interventions needs to meet the objectives of both researchers and participating organizations. This duality means that real-world impact has to be considered throughout the research process, simultaneously addressing both scientific rigour and practical relevance. This discussion paper aims to offer a set of principles, grounded in knowledge from various disciplines that can guide researchers in designing, implementing, and evaluating organizational interventions. Inspired by Mode 2 knowledge production, the principles were developed through a transdisciplinary, participatory and iterative process where practitioners and academics were invited to develop, refine and validate the principles. The process resulted in 10 principles: 1) Ensure active engagement and participation among key stakeholders; 2) Understand the situation (starting points and objectives); 3) Align the intervention with existing organizational objectives; 4) Explicate the program logic; 5) Prioritize intervention activities based on effort-gain balance; 6) Work with existing practices, processes, and mindsets; 7) Iteratively observe, reflect, and adapt; 8) Develop organizational learning capabilities; 9) Evaluate the interaction between intervention, process, and context; and 10) Transfer knowledge beyond the specific organization. The principles suggest how the design, implementation, and evaluation of organizational interventions can be researched in a way that maximizes both practical and scientific impact.

Feasibility of Virtual Focus Groups in Program Impact Evaluation.

Focus groups are often used for qualitative investigations. We adapted a published focus group method for evaluating impact of an organizational intervention for virtual delivery using video conferencing. The method entailed convening small groups of three to five participants for a 2-hour facilitated workshop. We delivered the virtual workshops, adding qualitative evaluation with researchers and participants, to assess the effectiveness of the protocol. We address the questions of how to structure the data collection procedures; whether virtual delivery permits cross participant interactions about a studied intervention; and how easy and comfortable the experience was for participants. Participants were university faculty members who were the focus of an institutional diversity program. The results indicated that the virtually delivered focus group workshop could be successfully implemented with strong fidelity to the original protocol to achieve the workshop goals. The workshops generated rich data about the impacts of the institutional program as well as other events and conditions in the working environment that were relevant to consider along with the observed program outcomes. A well-planned virtual focus group protocol is a valuable tool to engage intervention stakeholders for research and evaluation from a distance. Video conferencing is especially useful during the current COVID-19 pandemic, but also whenever geography separates researchers and evaluators from program stakeholders. Careful planning of privacy measures for a secure online environment and procedures for structured facilitation of group dialogue are critical for success, as in any focus group. This article addresses a gap in the literature on feasibility and methodology for using video conference technology to conduct qualitative data collection with groups.

A method for effect modifier assessment (EMA) in ergonomic intervention research.

The numerous opportunities for effect modifications pose a major challenge in ergonomic intervention research. Even studies in systematic reviews that are assessed as being of high quality generally lack any proper consideration of the potential effect modifiers. We have developed a method for effect modifier assessment (EMA) in intervention research. The EMA method uses a participatory workshop consisting of representatives from all occupational groups in the investigated organization. The workshop identifies both intervention and modifier events including "confounders" and "effect modifiers" according to epidemiologic terminology. These are categorized into themes, then analyzed and evaluated for their potential effects on the investigated outcomes. The overall impact of the pooled modifier themes is finally estimated in relation to the estimated impact of the intervention events. In the present study, the EMA method was tested in two cases. The findings suggest that it provides information that strengthens inferences about the impact of the investigated ergonomic interventions. Further evaluation of the method is recommended.

Relational coordination and organisational social capital association with characteristics of general practice.

Background. Relational coordination (RC) and organisational social capital (OSC) are measures of novel aspects of an organisation's performance, which have not previously been analysed together, in general practice. Objectives. The aim of this study was to analyse the associations between RC and OSC, and characteristics of general practice. Methods. Questionnaire survey study comprising 2074 practices in Denmark. Results. General practitioners (GPs) rated both RC and OSC in their general practice higher than their secretaries and nurses. The practice form was statistically significantly associated with high RC and OSC. RC was positively associated with the number of patients listed with a practice per staff, where staff is defined as all members of a practice including both owners and employees. Conclusion. The study showed that RC and OSC were significantly associated with type of profession and practice type. RC was also found to be significantly positively associated with number of patients per staff. However, the low response rate must be taken into consideration when interpreting the self-reported results of this study.

Design of systems for productivity and well being.

It has always been an ambition within the ergonomic profession to ensure that design or redesign of production systems consider both productivity and employee well being, but there are many approaches to how to achieve this. This paper identifies the basic issues to be addressed in light of some research activities at DTU, especially by persons responsible for facilitating design processes. Four main issues must be addressed: (1) determining the limits and scope of the system to be designed; (2) identifying stakeholders related to the system and their role in the system design; (3) handling the process' different types of knowledge; and (4) emphasizing that performance management systems, key performance indicators (KPIs), and leadership are also part of the system design and must be given attention. With the examples presented, we argue that knowledge does exist to help system design facilitators address these basic issues.

A new method for analyzing diagnostic delay in gynecological cancer.

OBJECTIVE: The aim of this article is to present a new methodology to illustrate, understand, and measure delay in health care. The method is inspired by process mapping tools as analytical framework and demonstrates its usefulness for studying diagnostic delay in gynecological cancer. MATERIALS AND METHODS: Six women with a diagnostic delay of 6 weeks or more before treatment of gynecological cancer at a specialized regional department (the Department of Gynecology and Obstetrics, Odense University Hospital, Denmark) were included in the study. Maps of existing processes were performed for each patient reflecting the patients' pathway through the course of the disease. We combined 2 process mapping tools, namely, value stream mapping and business process modeling notation. The first method identifies the flow in a process as timelines. The latter introduces a set of easily recognizable graphical elements. RESULTS: Detailed information concerning the cancer patients' pathway was obtained. The method visualized the complexities within the diagnostic pathway. The role of different participants (patient, general practitioner, and local hospitals) became clear by arranging activities according to responsibilities and was shown to recurrently influence and contribute to the delay in the diagnostic process. Some important contributors to diagnostic delay in gynecological cancer, such as lack of cancer suspicion, competing diseases, negative test results, inexpedient referral patterns, and referrals without cancer suspicion, were found. CONCLUSIONS: Our results point out process mapping tools as a potential analytical framework to illustrate, understand, and measure delay in health care. Furthermore, the method was able to identify important contributors to the diagnostic delay in gynecological cancer patients.

User-driven innovation of an outpatient department.

This paper presents experiences from a user-driven innovation process of an outpatient department in a hospital. The mixing of methods from user-driven innovation and participatory design contributed to develop an innovative concept of the spatial and organizational design of an outpatient department in a hospital. Design games and tabletop simulation seem to be powerful tools in facilitating such a participatory process.

Reasons for diagnostic delay in gynecological malignancies.

INTRODUCTION: To describe the different delay types in women with gynecological cancer and to analyze the relationship between diagnostic delay and a number of characteristics for patients, cancers, and the health care system. METHOD: Data were obtained from 4 different questionnaires, the Electronic Patient Journal (EPJ), and the Danish Gynecological Cancer Database (DGCD). A total of 161 women with ovarian cancer (63), endometrial cancer (50), cervical cancer (34), and vulvar cancer (14) were included. Outcome measures were different delay types counted in days and 4 clinically important variables' impact on the diagnostic delay: presence of alarm symptoms, age (divided into 2 groups: ≤60 or >60 years), performance of gynecological examination by the general practitioner (GP), and notification of cancer suspicion on first referral from GP. RESULTS: Across cancer types, median total delay was 101 days. Some 10% of women experienced the longest delay with a total delay of 436 days or more. Vulva cancer had the longest delay, whereas women with ovarian cancer had the shortest delay. More than one third (39%) of the women consulted their GP for reasons other than the predefined alarm symptoms. Gynecological examination by the GP was less likely to be performed if the woman did not present with vaginal bleeding. The length of the delay was shortened by performance of a gynecological examination by the GP and a primary referral from the GP raising the receiver's suspicion of cancer. CONCLUSION: Reducing diagnostic delays should be achievable, particularly for those most delayed, and interventions aimed at reducing delays need to be developed. Creation of new valid instruments for measuring delay is essential in future research.