Our findings suggest that the alcohol intake among Inuit, living in Denmark and in Greenland respectively, differs in relation to total intake, drinking patterns and a measure of alcohol dependence. Whether this may be attributed to urbanization, or to migration, is not clear.

Research has demonstrated how the translation of a new management concept into organizational practices is impacted by the translators’ engagement with their local context. We expand this literature by demonstrating how a heterogenous institutional context prompts translators to create practice change but also practice maintenance. Building upon an interpretive analytical framework we offer a way forward to examine relationships between societal institutions and distributed collective work in change processes. Our longitudinal qualitative study based upon interviews and observations examines how the concept of value-based healthcare was translated at a hospital. The translators developed three micro-tactics: disregard, maintenance, and displacement, grounded in their narration of practice changes. Translators enacted institutional logics differently at the levels of meaning and practice when they framed, rationalised, and contextualised the potentialities of a new concept, and this complexity provided the possibility of various practice outcomes. We contribute to the understanding of translation by demonstrating how a heterogenous institutional context encourages translators to change selected practices but also to decouple and maintain most of the existing practices due to their enactment of institutionalised rationalities. Moreover, we discuss how translation outcomes are impacted by collaborating actors’ shared interpretations of their institutional context. Collaborating translators need to agree on whether and what practice change is valuable for the organization, and change is only possible when they interpret that they have the leverage to align a new idea with dominant institutional logics.

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Background In 2018, the concept of clusters was introduced as a new model for data-driven quality improvement in general practice in Denmark. However, there is little research on the development and implementation of general practice clusters. The study explores how the cluster coordinators responsible for leading the clusters forward enacted and experienced their role during the early years of the clusters with attention to the challenges and enablers perceived in the process. Methods Qualitative, semi-structured interviews with 25 cluster coordinators from clusters that had carried out at least two meetings on a specific professional topic. The coordinators represented clusters of varying sizes and different geographic locations. Key topics in the interview guide were the development and structure of the cluster, the role of the coordinator, obtainment of data for the meetings, the role of external support, the form and content of the meetings, the participation and engagement of the members. A thematic analysis – shaped by the original aims and categories of the study while also being open to emerging themes – was performed on the transcribed interview material. Results Important enablers in the process of developing the clusters included the positive engagement of the GPs, the support offered by regional quality units and a national quality organisation for general practice, and the funding provided by the formal cluster framework. Challenges initially included setting up the clusters administratively and translating the open cluster concept into a local, workable model; and later obtaining relevant data for the cluster meetings and facilitating peer discussions about the data. Conclusion The coordinators generally experienced that the development of the clusters had progressed relatively fast with engagement from most of the participating GPs. Still, challenges with data obtainment, data analysis, and facilitation will have to be addressed ongoingly. Future research should investigate learning processes at the cluster meetings and how the clusters impact clinical practice and collaborative relations between general practice and other health care providers.

Ledelse i sundhedsvaesenet er område, som har fået stor forskningsmaessig opmaerksomhed -herunder problematiseringen af, hvordan ledelse udøves imellem nationalt formulerede styringsinitiativer og sundhedsprofessionernes strategier for at bevare deres autonomi og vidensmonopol. Det har ført til udviklingen af begreber såsom hybridledere og hybride professioner som kategorier, der formår at integrere styringsinitiativernes vaerktøjer og logikker med henholdsvis faglig ledelse og sundhedsprofessionernes grundkompetencer. I denne artikel er formålet vise, hvordan en ny aktør på danske hospitaler, såkaldte kvalitetskoordinatorer, medvirker til organisationsaendringer i mødet mellem styringsinitiativer og lokal klinisk praksis. Konkret viser analysen, hvordan kvalitetsstandarder kan blive et strategisk omdrejningspunkt for at knytte klinisk personale og ledelse sammen på tvaers af organisatoriske og professionelle skel.