While important insights have been provided into the role of HR managers in performing change in the workplace, still little is known about how HR managers themselves are shaped by change, in particular in relation to those changes triggered by radical or disruptive shock events and crisis situations, and in the public sector context. In this study, we aim to address this, using an exploratory qualitative interview study to explore how the serious and profound COVID-19 pandemic triggered boundary work among HR managers in public sector municipalities. Our findings illustrate that COVID-19 triggered HR managers to engage in boundary work in two main ways: either by defending their boundaries (through the two practices of counteracting dumping and counteracting shirking) or by expanding them (through the two practices of facilitating self-fulfillment and facilitating status-enhancement). We discuss how this variation is related to whether the HR managers experienced and made sense of the pandemic mainly as a threat—of being forced into unwanted responsibility—or if they experienced and made sense of it mainly as an opportunity to take advantage of the situation. In showing this, the study makes a number of important contributions to both theory and practice. © The Author(s) 2023.

The increased use of advanced technologies generating new data and information, including algorithmic technologies and AI, has led to a renewed interest in the role of technologies in knowledge work. Some of these technologies act as epistemic technologies, a term derived from the work of Knorr Cetina (1999) on how sciences make knowledge. While previous studies provide important insights into how the outcomes of the technologies are used in expert work, the work needed to produce the outcomes in the first place is often overlooked and separated from use. The generation of new data and information is instead treated as both black-boxed and de-contextualized. To highlight the work required to generate meaningful outcomes, and address the challenges posed by opaque algorithms, we present a longitudinal in-depth study of the medical imaging technologies of the Robotic X-ray and iMRI, used in combination with surgery. The study illustrates how technologies become epistemic through use: new data was produced by means of interactions within a relational and heterogeneous assemblage of people, technologies and devices. Through trained judgement, the experts made the data useful and possible to act upon in each specific situation. The study contributes to research into the use of algorithmic technologies in knowledge work by showing how opaque algorithms can be complemented by contextualized information, making it possible to interrogate and make trained judgements, not only in relation to outcomes, but also their production. We conclude that epistemic technologies are involved in the ongoing construction of knowledge, during both the production and use of outcomes, and that enacting the technologies as epistemic includes a situational and material awareness. © The Author(s) 2025.

Purpose – The purpose of this paper isto contribute to a grounded understanding of how mobility impactstalentdesignation and with what consequences.

Design/methodology/approach – An exploratory qualitative case study was conducted of a global medicaltechnology corporation, based on interviews with HR managers, line managers and non-managerial employees.

Findings – The findings illustrate that mobility plays a significant role in how employees are assigned talentstatus, and that mobility manifests and impacts talent designation through two types – geographical and lateralmobility. Mobility is not determined based on abilities and competencies, but rather on an employee’s overallpersonal situation, including age, family status and relationship status. Two main practices emerged throughwhich these determinants were decided: direct questioning and guesswork. The consequences that follow arethat individuals are left with little room to influence their own talent situation, and that there is a risk ofdiscriminatory and exclusionary consequences arising.

Originality/value – The study makes two main contributions. First, it provides a more nuanced understandingof how talent designation unfolds in practice, showing that performance and potential alone cannot explain theprocess and emphasizing the consequential role of mobility. Second, it contributes with knowledge about theconsequences of basing talent designation heavily on mobility. Individual employees are left with significantlyless room for enacting agency and playing active roles in relation to TM than has been suggested. Added to thisare the potential discriminatory and exclusionary consequences.

Background: Artificial intelligence (AI) holds significant promise for enhancing the efficiency and safety of medical history-taking and triage within primary care. However, there remains a dearth of knowledge concerning the practical implementation of AI systems for these purposes, particularly in the context of healthcare leadership. This study explores the experiences of healthcare leaders regarding the barriers to implementing an AI application for automating medical history-taking and triage in Swedish primary care, as well as the actions they took to overcome these barriers. Furthermore, the study seeks to provide insights that can inform the development of AI implementation strategies for healthcare.

Methods: We adopted an inductive qualitative approach, conducting semi-structured interviews with 13 healthcare leaders representing seven primary care units across three regions in Sweden. The collected data were subsequently analysed utilizing thematic analysis. Our study adhered to the Consolidated Criteria for Reporting Qualitative Research to ensure transparent and comprehensive reporting.

Results: The study identified implementation barriers encountered by healthcare leaders across three domains: (1) healthcare professionals, (2) organization, and (3) technology. The first domain involved professional scepticism and resistance, the second involved adapting traditional units for digital care, and the third inadequacies in AI application functionality and system integration. To navigate around these barriers, the leaders took steps to (1) address inexperience and fear and reduce professional scepticism, (2) align implementation with digital maturity and guide patients towards digital care, and (3) refine and improve the AI application and adapt to the current state of AI application development.

Conclusion: The study provides valuable empirical insights into the implementation of AI for automating medical history-taking and triage in primary care as experienced by healthcare leaders. It identifies the barriers to this implementation and how healthcare leaders aligned their actions to overcome them. While progress was evident in overcoming professional-related and organizational-related barriers, unresolved technical complexities highlight the importance of AI implementation strategies that consider how leaders handle AI implementation in situ based on practical wisdom and tacit understanding. This underscores the necessity of a holistic approach for the successful implementation of AI in healthcare. © The Author(s) 2024.

A digital transformation of Swedish healthcare is currently taking place, and artificial intelligence (AI) is meant to solve many of the healthcare sector's challenges. The objective of this paper is to describe and analyze how the boundaries around the physicians' work could change when AI is implemented in healthcare and what boundary work actors on different levels in a healthcare system conduct. We conducted 26 semi-structured interviews with healthcare leaders and 18 with healthcare managers and professionals. The result shows that the leaders, healthcare managers, and healthcare professionals describe different types of boundary work in regard to the implementation of AI. The implementation of AI in healthcare could change the boundaries around the healthcare professionals’ work and generate new kinds of boundary work that could affect the implementation. These findings can inform both practice and policy.

The promise behind many advanced digital technologies in healthcare is to provide novel and accurate information, aiding medical experts to navigate and, ultimately, decrease uncertainty in their clinical work. However, sociological studies have started to show that these technologies are not producing straightforward objective knowledge, but instead often become associated with new uncertainties arising in unanticipated places and situations. This study contributes to the body of work by presenting a qualitative study of an Artificial Intelligence (AI) algorithm designed to predict the risk of mortality in patients discharged to home from the emergency department (ED). Through in-depth interviews with physicians working at the ED of a Swedish hospital, we demonstrate that while the AI algorithm can reduce targeted uncertainty, it simultaneously introduces three new forms of uncertainty into clinical practice: epistemic uncertainty, actionable uncertainty and ethical uncertainty. These new uncertainties require deliberate management and control, marking a shift from the physicians' accustomed comfort with uncertainty in mortality prediction. Our study advances the understanding of the recursive nature and temporal dynamics of uncertainty in medical work, showing how new uncertainties emerge from attempts to manage existing ones. It also reveals that physicians’ attitudes towards, and management of, uncertainty vary depending on its form and underscores the intertwined role of digital technology in this process. By examining AI in emergency care, we provide valuable insights into how this epistemic technology reconfigures clinical uncertainty, offering significant theoretical and practical implications for the integration of AI in healthcare. © 2024 The Authors

A digital transformation of Swedish healthcare is currently taking place, and artificial intelligence (AI) is meant to solve many of the healthcare sector's challenges. The objective of this paper is to describe and analyze how the boundaries around the physicians' work could change when AI is implemented in healthcare and what boundary work actors on different levels in a healthcare system conduct. We conducted 26 semi-structured interviews with healthcare leaders and 18 with healthcare managers and professionals. The result shows that the leaders, healthcare managers, and healthcare professionals describe different types of boundary work in regard to the implementation of AI. The implementation of AI in healthcare could change the boundaries around the healthcare professionals’ work and generate new kinds of boundary work that could affect the implementation. These findings can inform both practice and policy.

Svensk primärvård står inför stora utmaningar med en åldrande befolkning och ett ökat antal personer som vårdas i hemmet (Landers et al., 2016). Digital teknik implementeras med förhoppning om att förbättra kommunikationen mellan vårdpersonal och underlätta möjligheterna till egenvård och tillgänglighet för patienter (Socialstyrelsen, 2021). Tidigare studier visar att användningen av digital teknik kan förändra det professionella landskapet (Petersson, 2020) och påverka arbetsmiljö och arbetets innehåll (Ertner, 2019). Trots att teknik som implementeras inom vården bör vara anpassad till hälso- och sjukvårdspersonalens arbete och värderingar (Palmer et al., 2019; Reed et al., 2019) är sjuksköterskor sällan involverade i beslut kring utformning eller implementering av ny teknik (von Gerich et al., 2022). Det behövs mer kunskap om hur digitaliseringen kan ske i samproduktion med sjuksköterskor och utformas så att en god arbetsmiljö bibehålls.

Presentationen syftar till att beskriva sjuksköterskors arbete och arbetsmiljö inom hemsjukvården och hur dessa kunskaper kan användas vid utvecklingen och implementeringen av framtida digital teknik.

Individuella semi-strukturerade intervjuer har genomförts med 20 sjuksköterskor som arbetar på vårdcentral och inom hemsjukvård i två halländska kommuner. Intervjuerna har analyserats genom kvalitativ innehållsanalys (Hsieh & Shannon, 2005). Implementeringsteoretiska ramverk används för att undersöka hur kunskapen kan inkorporeras vid innovation och implementering av digitala tekniker inom vårdverksamheter (Nilsen, 2015).

Preliminära resultat kommer att presenteras vid konferensen.

Referenser

Ertner, S. M. (2019). Enchanting, evoking, and affecting: the invisible work of technology implementation in homecare. Nordic Journal of Working Life Studies, 9(S5), 33-47.

Hsieh, H.-F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis. Qualitative health research, 15(9), 1277-1288.

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D., Lee, T., Moorhead, T., Rodriguez, S., & Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home Health Care Management & Practice, 28(4), 262-278.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation science : IS, 10(1), 53-53.

Palmer, V. J., Weavell, W., Callander, R., Piper, D., Richard, L., Maher, L., Boyd, H., Herrman, H., Furler, J., & Gunn, J. (2019). The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement. Medical humanities, 45(3), 247-257.

Petersson, L. (2020). Paving the way for transparency: How eHealth technology can change boundaries in healthcare Lund University].

Reed, J. E., Howe, C., Doyle, C., & Bell, D. (2019). Successful healthcare improvements from translating evidence in complex systems (SHIFT-Evidence): simple rules to guide practice and research. International journal for quality in health care, 31(3), 238-244.

Socialstyrelsen. (2021). E-hälsa och välfärdsteknik i kommunerna 2021. Uppföljning av den digitala utvecklingen i socialtjänsten och den kommunala hälso-och sjukvården.

von Gerich, H., Moen, H., Block, L. J., Chu, C. H., DeForest, H., Hobensack, M., Michalowski, M., Mitchell, J., Nibber, R., & Olalia, M. A. (2022). Artificial Intelligence-based technologies in nursing: A scoping literature review of the evidence. International Journal of Nursing Studies, 127, 104153.

While leadership is one of the most discussed concepts in the social sciences, there is a need for more scholarly research that examines the ambiguous leadership position of middle managers, and how their leadership work is perceived in practice. In this article, we follow the recent research turn of adopting a social constructionist view of leadership, and make use of metaphors to answer the following research question: how are middle managers in the public sector managing the expectations and demands from both top management and subordinates, and what are some of its consequences? We study this in the public sector, a context of particular importance but one that has often been neglected in previous research. Through a qualitative in-depth case study, based on observations, interviews, and organizational documents, our findings show that middle managers were trapped in the way they moved between being constructed as a leader and a follower, along what we call a leader-follower pendulum, and in the way they enacted two different leadership metaphors: the buddy and the commander. These aspects jointly contribute to a complex and ambiguous situation for middle managers, which in turn gives rise to alienation and the constant strive to fit in, something that we metaphorically refer to as “karma chameleon.” © 2022 The Author(s).

Talent management (TM) continues to attract considerable attention from both practitioners and academics. Existing research investigating employee reactions to being awarded talent status has not elucidated the processual nature of such reactions. This study extends TM research by providing a nuanced understanding of how employees react to talent designation over time and why. Specifically, it distinguishes between short- and long-term reactions and uses the lenses of psychological contract (PC) theory and social identity theory (SIT) to unpack mechanisms underlying immediate positive, and delayed negative, employee reactions to talent designation. Results from qualitative analysis of interviews with talents in three organizations show how—as time elapsed and no identity-relevant events occurred—perceptions of “talent emptiness” and “indeterminacy” developed. The study unfolds the complex interaction between SIT and PC (including breach and violation) to explain talents’ evolving reactions over time. As such, it contributes to TM literature by providing a nuanced understanding of the processes underlying employee reactions in exchanges involving socioemotional resources. © 2022 The Authors.