Healthcare is an information-intensive field, as information is needed to make strategic, tactical, and operational decisions. The purpose of this study was to identify the tactical decisions that middle management healthcare managers make, the information that is available, and the necessary information that is missing using the cardiac care process as an example. Data were collected through focused interviews of nurses and physicians who work in middle management in a secondary healthcare field. The interviews were coded and analyzed using the thematic content analysis method. We identified two main categories of tactical decisions: those concerning the process of care and those concerning the resources for the care. We termed the categories "process decisions" and "resource decisions." The availability of information varied. Much of the necessary information was created and processed manually. Our results show that the collection, mining, and systematic use of information are difficult because of the existence of many types of information systems and their varying abilities to produce and report information. Finally, much of the important information is missing. In conclusion, the information management process in healthcare settings needs to be improved, and a new generation of information system is needed to support tactical decision making in middle management.

The main goal of the Nordic project Quality Assurance in Higher Education was to develop and implement a self-evaluation model in the participating Higher Education Institutes (HEIs) to support their quality assurance work and continuous curriculum development. Furthermore, the project aimed at strengthening the cooperation of HEIs in quality assurance (QA) and disseminating good practices of QA. The framework of development is based on the CDIO approach and the CDIO self-evaluation process. The main results are a detailed definition of the self-evaluation process, well-documented self-evaluations of the participating degree programmes, and the identification of the main development areas and actions in each participating degree programme. Furthermore, the project has increased the partners’ understanding of other partners and their challenges. Finally, quality assurance has been enhanced in each participating programme and new ideas and support for quality assurance work in other higher education institutes have been produced.

This article discusses the tension between quality assurance and quality enhancement in engineering education at programme level. It acknowledges that accreditation has evolved for many years, but does not agilely support innovation or implement changes in educational programmes. Existing quality assurance systems, institutional collaboration networks, as well as new innovative quality enhancement models and processes are described, contrasted and synthesised. Quality enhancement is analysed based on its function as a source of inspiration and dissemination of good practice. The article reflects on a novel and more collaborative approach to quality enhancement, built on the foundations of specific pedagogical standards and rubrics (e.g. CDIO). One solution leading to real continuous quality enhancement could be flexible and agile evaluation processes. These are founded on measurement and rating frameworks and complemented with quality assurance for engineering education. Incremental enhancement is based on relevant needs identified collaboratively between programmes.