Organiserande och kvalitetsutveckling : om sönderfall, upprätthållande och begripliggörande i arbetslivet

Sammanfattning: The study explores the interaction of general management ideas like TQM (here referred to as technocratic visions) and microprocesses of narrating and organizing in two different contexts: the public sector (health care) and the private sector (manufacturing) in Sweden. The purpose is to provide a better understanding of what happens when models of this type are introduced into a work organization. The theoretical perspective of the study highlights narratives and organizing. I use the term organizing as representing the interplay of at least three types of processes: continuity, dissolution and sensemaking. Technocratic visions are also discussed in relation to the evolution of different social and economic patterns that are manifested in a search for new organizational forms as well as in a search for new identities at the personal level. The first study was undertaken at two hospital clinics in 1994 and 1995. A total of 31 persons from different occupational groups were interviewed on two occasions each, a questionnaire was also administered (n=183). The second study was carried out in three factories, in 1996-1997. A total of 53 persons were interviewed, either individually or in groups. In the clinics, four narrative styles were described. Heroic professionalism and integrative cooperation were typically used by doctors and nurses whereas emotional elaboration and passive dependence tended to be more common among staff nurses. The different narrative styles are thus related to such issues as those of influence, gender and profession. Commitment to the quality program and self-reported changes in one's job and in one's way of thinking about it was found to be positively related to the experience of control over one's work situation, and to morale commitment to the organization, and to be negatively related to a sense of alienation toward the organization. In the factories a number of problematic situations were described. The dominant interpretation of quality management and the practices employed in efforts to attain continuous improvement tended to reproduce an image of rational decision making and project management that supposedly relied on formal knowledge and skills. One way of making sense out of the whole specter of problematic situations was to organize the different elements into a narrative of planned change, in which managers are the ones who have to teach, implement, sell and create interest in the new methods involved. In this quest, they have to overcome resistance, skepticism and ignorance. The sensemaking devices play an important role in organizing and in creating periods of continuity and relative stability. The order achieved, however, may be at the expense of excluding other ways of narrating and making sense of things, which could provide a richer and more varied background for the work situation. Sensemaking activities can thus both facilitate and complicate the execution of tasks, quality, the maintenance of health at the place of work, and in a broader sense as well, involving the conditions for learning, dialogue and democratic participation