Division of Community Medicine, Department of Medical and Health Services, Linköping University, 581 83, Linköping, Sweden.
HELIX Competence Centre, Linköping University, Linköping, Sweden.
J Occup Rehabil. 2018 Dec;28(4):730-739. doi: 10.1007/s10926-018-9759-9.
Purpose Management principles in insurance agencies influence how benefits are administered, and how return to work processes for clients are managed and supported. This study analyses a change in managerial principles within the Swedish Sickness Insurance Agency, and how this has influenced the role of insurance officials in relation to discretion and accountability, and their relationship to clients. Methods The study is based on a qualitative approach comprising 57 interviews with officials and managers in four insurance offices. Results The reforms have led to a change in how public and professional accountability is defined, where the focus is shifted from routines and performance measurements toward professional discretion and the quality of encounters. However, the results show how these changes are interpreted differently across different layers of the organization, where New Public Management principles prevail in how line managers give feedback on and reward the work of officials. Conclusions The study illustrates how the introduction of new principles to promote officials' discretion does not easily bypass longstanding management strategies, in this case managing accountability through top-down performance measures. The study points out the importance for public organizations to reconcile new organizational principles with the current organizational culture and how this is manifested through managerial styles, which may be resistant to change. Promoting client-oriented and value-driven approaches in client work hence needs to acknowledge the importance of organizational culture, and to secure that changes are reflected in organizational procedures and routines.
目的 保险代理中的管理原则影响着福利的管理方式，以及客户重返工作岗位的流程的管理和支持方式。本研究分析了瑞典工伤保险局管理原则的变化，以及这如何影响保险官员在酌处权和问责制方面的角色，以及他们与客户的关系。 方法 该研究基于定性方法，包括对四个保险办公室的 57 名官员和管理人员的访谈。 结果 改革导致了对公共和专业问责制的定义发生了变化，重点从日常工作和绩效衡量转向了专业酌处权和互动质量。然而，结果表明，这些变化在组织的不同层次上有不同的解释，在那里，新公共管理原则在一线经理对官员的工作进行反馈和奖励方面占主导地位。 结论 本研究说明了引入新原则以促进官员的酌处权并不容易绕过长期存在的管理策略，在这种情况下，通过自上而下的绩效衡量来管理问责制。该研究指出，对于公共组织来说，将新的组织原则与当前的组织文化协调起来是很重要的，而这是通过管理风格表现出来的，这种风格可能抵制变革。因此，在客户工作中推广以客户为导向和以价值为驱动的方法需要认识到组织文化的重要性，并确保变化反映在组织程序和日常工作中。
