Tietojohtaminen projektissa: hankevastaavan ja projektipäällikön näkökulmia

Tutkimuksen tavoitteena oli selvittää miten tietojohtamisen eri osatekijät näkyvät projektin läpiviemisen aikana. Teoreettinen viitekehys kokoaa projektijohtamisen osatekijät ja tietojohtamisen kolme pääelementtiä (tiedon hankinta, tiedon säilyttäminen ja tiedon siirto) yhteen projektin elinkaaren ympärille. Tutkimus toteutettiin laadullisena tutkimuksena, jonka empiirinen osuus suoritettiin haastattelemalla projektin asiakkaan vastuuhenkilöitä sekä toimittajan vastuuhenkilöitä yksi kerrallaan. Näiden lisäksi suoritettiin ryhmähaastattelu kohderyhmän portfoliohallitsijoiden kesken. Empiriasta saadut tulokset mallinnettiin viitekehyksen mukaisesti tietojohtamisen pääelementeille. Tiedon hankinnassa projektijohtamisen kentästä korostui sidosryhmät ja riskit, tiedon säilyttämisessä korostui integrointi ja viestintä sekä tiedon siirtämisessä korostui aika ja HR. Projektin aikana luodun ja hankitun osaamisen ja oppien säilyttäminen koettiin haastateltavien mukaan tietojohtamisen osatekijöistä haastavimmaksi. Alatutkimuskysymyksenä selvitetyt esteet ja hidasteet tietojohtamisen menetelmille kulminoituivat haastatteluissa prosesseihin, vastuisiin ja systemaattisuuden puuttumiseen. Haastatteluiden ja kirjallisuustutkimuksen tuloksena tehtiin kohdeyritykseen suosituksia tietojohtamisen elementtien hyödyntämisessä projekteissa.

Liiketoimintatiedonhallinnan hyödyntämisen esteet päätettäessä palveluista. Case: Kunnalliset pelastustoimen liikelaitokset ja eriytetyt taseyksiköt

Pelastuslaitosten liiketoimintatiedonhallinnalla, tietoperusteisuudella ja tietojohtamisella on tulevaisuudessa merkittävä rooli päätettäessä palveluista. Julkisen pelastustoimen kuntien liikelaitoksina ja eriytettyinä taseyksiköinä toimivien pelastuslaitosten haasteet tulevat olemaan jatkossa tehokkaiden ja vaikuttavien palveluiden strategisessa johtamisessa ja suunnittelussa. Näistä asioista päättäminen on kriittinen vaihe onnistumisen kannalta. Päätöksenteko eri tasoilla tarvitsee tuekseen toiminnasta ja palveluista kanavoitua analysoitua tietoa. Asiakastarpeesta lähtevä vaikuttavuus ja laatu korostuvat. Liiketoimintatiedonhallinta ja tietoperusteisuus haastavat pelastuslaitoksen johtamisjärjestelmän. Johtamisen kyvykkyys ja henkilöstön osaaminen ovat tietoperusteisuuden ja tiedonhallinnan keskiössä. Systemaattisen liiketoimintatiedonhallinnan ja tietoperusteisuuden erottaa perinteisestä virkamiehen tietojen hyväksikäytöstä käsitteen kokonaisvaltaisuus ja järjestelmällisyys kaikessa tiedollisessa toiminnassa. Tämä kattaa tietojärjestelmät, mittarit, prosessit, strategian suunnitelmat, asiakirjat, raportoinnin, kehittämisen ja tutkimuksen. Liiketoimin-tatiedonhallinta ja tietojohtaminen linkittävät kaiken toisiinsa muodostaen keskinäisriippuvaisen yhtenäisen järjestelmän ja kokonaisvaltaisen ymmärryksen. Tutkimukseni on laadullinen tutkimus jossa tiedon keruu ja analysointi on toteutettu toisiaan tukevilla tutkimusotteilla. Metodologia nojaa teorialähtöiseen systemaattiseen analyysiin, jossa on valikoituja osia sisällön analyysistä. Tutkimuksessa on käytetty aineisto- ja menetelmätriangulaatioita. Tutkimuksen aineisto on kerätty teemahaastatteluilla valittujen kohde pelastuslaitosten asiantuntijoilta palveluiden päätös- ja suunnittelutasolta, johtoryhmistä ja joh-tokunnista. Haastatteluja varten tutkija on tutustunut kohdepelastuslaitosten palveluita mää-rittävään tiedolliseen dokumentaatioon kuten palvelutasopäätöksiin ja riskianalyyseihin. Ai-neisto keruun kohteiksi valikoitui pääkaupunkiseudun alueen pelastuslaitokset: Helsingin kaupungin pelastuslaitos sekä Itä-, Keski- ja Länsi-Uudenmaan pelastuslaitokset. Tulosten mukaan pelastuslaitosten keskeiset liiketoimintatiedonhallinnan esteet muodostuvat johtamisen ongelmista, organisaation muutosvastarinnasta ja päätöksenteon tietoperusteen puutteesta. Nämä ilmenevät strategisen johtamisen puutteina, vaikuttavuuden mittaamisen sekä tiedon jalostamisen ongelmina. Keskeistä tiedollista yhdistävää ja linkittävää tekijää ei tunnisteta ja löydetä. Tiedollisessa liiketoimintatiedonhallinnan prosessityössä voisi olla tulos-ten mukaan mahdollisuuksia tämän tyhjiön täyttämiseen. Pelastuslaitoksille jää tulevaisuudessa valinta suunnasta johon ne haluavat edetä tiedonhal-linnan, tietojohtamisen ja tietoperusteisuuden kanssa. Tämä vaikuttaa kehitykseen ja tavoitteeseen keskeisistä palveluiden päätöksentekoa tukevista johtamis- ja tietojärjestelmistä, tietoa kokoavista ja luovista dokumenteista sekä organisaation joustavasta rakenteesta. Tietoprosessiin, tiedon prosessimaiseen johtamiseen ja systemaattiseen tiedonhallintaan meneminen vaikuttaa tutkimuksen tulosten mukaan lupaavalta mahdollisuudelta. Samalla se haastaa pelauslaitokset suureen kulttuuriseen muutokseen ja asettaa uusien vaikuttavuusmittareiden tuottaman tiedon ennakoivan hyväksynnän vaateen strategiselle suunnittelulle. Tämä vaatii pelastuslaitosten johdolta ja henkilöstöltä osaamista, yhteisymmärrystä, muutostarpeiden hyväksyntää sekä asiakkaan asettamista vaikuttavuuden keskiöön.

Integrating Use of Customer Information Throughout Multiple Sales Channels to Create Customer Competence

Customer knowledge management (CKM) practices enable organizations to create customer competence with systematic use of customer information that is integrated throughout the organization. Nonetheless, organizations are not able to fully exploit the vast amount of data available. Previous research on use of customer information is limited especially in a multichannel environment. The aim of this study was to identify the main obstacles for utilizing customer information efficiently across multiple sales channels. The study was conducted as a single case study in order to gain deeper understanding of the research problem. The empirical findings indicate that lack of CKM practices and a common goal are major challenges obstructing effective utilization of customer information. Furthermore, decentralized organizational structure and insufficient analytical skills create obstacles for information sharing and capabilities to process information and create new knowledge. The implications of the study suggest that in order to create customer competence organizations should shift their focus from technology to the organizational factors affecting use of information and implement CKM practices throughout the organization.

Management of Soft Information in Sales and Operations Planning

With a Sales and Operations Planning (S&OP) process, a company aims to manage the demand and supply by planning and forecasting. The studied company uses an integrated S&OP process to improve the company's operations. The aim of this thesis is to develop this business process by finding the best possible way to manage the soft information in S&OP, whilst also understanding the importance and types (assumptions, risks and opportunities) of soft information in S&OP. The soft information in S&OP helps to refine future S&OP planning, taking into account the uncertainties that affect the balance of the long-term demand and supply (typically 12-18 months). The literature review was used to create a framework for soft information management process in S&OP. There were not found a concrete way how to manage soft information in the existing literature. In consequence of the poor literature available the Knowledge Management literature was used as the base for the framework creation, which was seen in the very same type of information management like the soft information management is. The framework created a four-stage process to manage soft information in S&OP that included also the required support systems. First phase is collecting and acquiring soft information in S&OP, which include also categorization. The categorization was the cornerstone to identify different requirements that needs to be taken into consideration when managing soft information in S&OP process. The next phase focus on storing data, which purpose is to ensure the soft information is managed in a common system (support system) in a way that the following phase makes it available to users in S&OP who need by help of sharing and applications process. The last phase target is to use the soft information to understand assumptions and thoughts of users behind the numbers in S&OP plans. With this soft management process the support system will have a key role. The support system, like S&OP tool, ensures that soft information is stored in the right places, kept up-to-date and relevancy. The soft information management process in S&OP strives to improve the relevant soft information documenting behind the S&OP plans into the S&OP support system. The process offers an opportunity to individuals to review, comment and evaluate soft information in S&OP made by their own or others. In the case company it was noticed that without a properly documented and distributed soft information in S&OP it was seen to cause mistrust towards the planning.

Evaluating the Strategic Objectives of Cameroonian Higher Education: An application of the Balanced Scorecard

Contemporary higher education operates in an environment of dwindling and parsimonious resources; the increasing need for accountability and relevance to varying stakeholders with differing expectations. These relatively new trends in higher education have been faced by business organizations which have developed different ways of operating in response. This study outlines one way by which business organizations have addressed similar circumstances to show how the Cameroon higher education (HE) could learn from business organizations to manage strategic objectives. The balanced scorecard (BSC) has been used by business organizations to address similar trends. This study evaluates the strategic objectives of Cameroonian higher education using the balanced scorecard. The system level is used to identify the general strategic objectives and one state university is used to represent the translation and implementation of the objectives at the institution level. The BSC principles used include: operational strategic objectives; organizational alignment to the strategy; making strategy everyone’s everyday job; making strategy continual and; mobilizing the leadership for change. The underlying concepts in these principles are communication, consensus, relevance, and a participatory approach. The study employs data from policy documents, relevant literature, websites and semi-structured interviews. The research approach is qualitative and the analyses are done by making meaning of phenomena in their natural contexts. The results show that there is a general knowledge of the strategic objectives but there is disagreement on the relevance of these objectives to HE and on the type of approaches used in implementing the objectives. It was also found that the relevant stakeholders are known, but not all the respondents agree on the importance of these stakeholders. All stakeholders do not have the same level of influence-the state is the most influential. Reporting is sufficiently done but there are insufficient provisions for feedback from stakeholders. The study concludes that the BSC principles can be applied to the management of strategic objectives in Cameroon HE. For Cameroonian higher education, it is recommended that the focus should be first, on developing tools for strategy before the strategy itself. Even though the need for the BSC is confirmed the context does not seem sufficiently ready to implement the BSC as a strategic management tool. The proposed BSC framework can only be used as a communication tool. The barriers to managing strategic objectives in Cameroon HE are related to the communication, consensus, clarity and relevance. However, the system has prospects for improved management and eventual adoption of the BSC as both a strategic management and communication tool. In line with other BSC applications to higher education, this study concluded that it is more feasible to apply the balanced scorecard to a single higher education institution than to a higher education system. The study makes a contribution to the BSC by showing how its principles can be used in a non-business context. The study also opens up possibilities for future research on the same topic in a different context or the same context with a wider scope (more institutions and respondents); the same study with a deeper focus on the interrelationships between the different strategic objectives (strategy maps). The study could also be extended by including the perspectives of the identified stakeholders who are not directly part of the higher education system but constitute the environment in which higher education operates.

Effect of the Knowledge Representation Form on the Efficiency of Knowledge Sharing

The goal of this thesis is to estimate the effect of the form of knowledge representation on the efficiency of knowledge sharing. The objectives include the design of an experimental framework which would allow to establish this effect, data collection, and statistical analysis of the collected data. The study follows the experimental quantitative design. The experimental questionnaire features three sample forms of knowledge: text, mind maps, concept maps. In the interview, these forms are presented to an interviewee, afterwards the knowledge sharing time and knowledge sharing quality are measured. According to the statistical analysis of 76 interviews, text performs worse in both knowledge sharing time and quality compared to visualized forms of knowledge representation. However, mind maps and concept maps do not differ in knowledge sharing time and quality, since this difference is not statistically significant. Since visualized structured forms of knowledge perform better than unstructured text in knowledge sharing, it is advised for companies to foster the usage of these forms in knowledge sharing processes inside the company. Aside of performance in knowledge sharing, the visualized structured forms are preferable due the possibility of their usage in the system of ontological knowledge management within an enterprise.

Trust Embedded Open Innovation: Human-Centricity in the Financial

Globalization and interconnectedness in the worldwide sphere have changed the existing and prevailing modus operandi of organizations around the globe and have challenged existing practices along with the business as usual mindset. There are no rules in terms of creating a competitive advantage and positioning within an unstable, constantly changing and volatile globalized business environment. The financial industry, the locomotive or the flagship industry of global economy, especially, within the aftermath of the financial crisis, has reached a certain point trying to recover and redefine its strategic orientation and positioning within the global business arena. Innovation has always been a trend and a buzzword and by many has been considered as the ultimate answer to any kind of problem. The mantra Innovate or Die has been prevailing in any organizational entity in a, sometimes, ruthless endeavour to develop cutting-edge products and services and capture a landmark position in the market. The emerging shift from a closed to an open innovation paradigm has been considered as new operational mechanism within the management and leadership of the company of the future. To that respect, open innovation has been experiencing a tremendous growth research trajectory by putting forward a new way of exchanging and using surplus knowledge in order to sustain innovation within organizations and in the level of industry. In the abovementioned reality, there seems to be something missing: the human element. This research, by going beyond the traditional narratives for open innovation, aims at making an innovative theoretical and managerial contribution developed and grounded on the on-going discussion regarding the individual and organizational barriers to open innovation within the financial industry. By functioning across disciplines and researching out to primary data, it debunks the myth that open innovation is solely a knowledge inflow and outflow mechanism and sheds light to the understanding on the why and the how organizational open innovation works by enlightening the broader dynamics and underlying principles of this fascinating paradigm. Little attention has been given to the role of the human element, the foundational pre-requisite of trust encapsulated within the precise and fundamental nature of organizing for open innovation, the organizational capabilities, the individual profiles of open innovation leaders, the definition of open innovation in the realms of the financial industry, the strategic intent of the financial industry and the need for nurturing a societal impact for human development. To that respect, this research introduces the trust-embedded approach to open innovation as a new insightful way of organizing for open innovation. It unveils the peculiarities of the corporate and individual spheres that act as a catalyst towards the creation of productive open innovation activities. The incentive of this research captures the fundamental question revolving around the need for financial institutions to recognise the importance for organizing for open innovation. The overarching question is why and how to create a corporate culture of openness in the financial industry, an organizational environment that can help open innovation excel. This research shares novel and cutting edge outcomes and propositions both under the prism of theory and practice. The trust-embedded open innovation paradigm captures the norms and narratives around the way of leading open innovation within the 21st century by cultivating a human-centricity mindset that leads to the creation of human organizations, leaving behind the dehumanization mindset currently prevailing within the financial industry.

Collectiveness within startup teams – Leading the way to initiating and managing collective pursuit of opportunities in organizational contexts

While traditional entrepreneurship literature addresses the pursuit of entrepreneurial opportunities to a solo entrepreneur, scholars increasingly agree that new ventures are often founded and operated by entrepreneurial teams as collective efforts especially in hightechnology industries. Researchers also suggest that team ventures are more likely to survive and succeed than ventures founded by the individual entrepreneur although specific challenges might relate to multiple individuals being involved in joint entrepreneurial action. In addition to new ventures, entrepreneurial teams are seen central for organizing work in established organizations since the teams are able to create major product and service innovations that drive organizational success. Acknowledgement of the entrepreneurial teams in various organizational contexts has challenged the notion on the individual entrepreneur. However, considering that entrepreneurial teams represent a collective-level phenomenon that bases on interactions between organizational members, entrepreneurial teams may not have been studied as indepth as could be expected from the point of view of the team-level, rather than the individual or the individuals in the team. Many entrepreneurial team studies adopt the individualized view of entrepreneurship and examine the team members’ aggregate characteristics or the role of a lead entrepreneur. The previous understandings might not offer a comprehensive and indepth enough understanding of collectiveness within entrepreneurial teams and team venture performance that often relates to the team-level issues in particular. In addition, as the collective-level of entrepreneurial teams has been approached in various ways in the existing literatures, the phenomenon has been difficult to understand in research and practice. Hence, there is a need to understand entrepreneurial teams at the collective-level through a systematic and comprehensive perspective. This study takes part in the discussions on entrepreneurial teams. The overall objective of this study is to offer a description and understanding of collectiveness within entrepreneurial teams beyond individual(s). The research questions of the study are: 1) what collectiveness within entrepreneurial teams stands for, what constitutes the basic elements of it, and who are included in it, 2) why, how, and when collectiveness emerges or reinforces within entrepreneurial teams, and 3) why collectiveness within entrepreneurial teams matters and how it could be developed or supported. In order to answer the above questions, this study bases on three approaches, two set of empirical data, two analysis techniques, and conceptual study. The first data set consists of 12 qualitative semi-structured interviews with business school students who are seen as prospective entrepreneurs. The data is approached through a social constructionist perspective and analyzed through discourse analysis. The second data set bases on a qualitative multiplecase study approach that aims at theory elaboration. The main data consists of 14 individual and four group semi-structured thematic interviews with members of core entrepreneurial teams of four team startups in high-technology industries. The secondary data includes publicly available documents. This data set is approached through a critical realist perspective and analyzed through systematic thematic analysis. The study is completed through a conceptual study that aims at building a theoretical model of collective-level entrepreneurship drawing from existing literatures on organizational theory and social-psychology. The theoretical work applies a positivist perspective. This study consists of two parts. The first part includes an overview that introduces the research background, knowledge gaps and objectives, research strategy, and key concepts. It also outlines the existing knowledge of entrepreneurial team literature, presents and justifies the choices of paradigms and methods, summarizes the publications, and synthesizes the findings through answering the above mentioned research questions. The second part consists of five publications that address independent research questions but all enable to answer the research questions set for this study as a whole. The findings of this study suggest a map of relevant concepts and their relationships that help grasp collectiveness within entrepreneurial teams. The analyses conducted in the publications suggest that collectiveness within entrepreneurial teams stands for cognitive and affective structures in-between team members including elements of collective entity, collective idea of business, collective effort, collective attitudes and motivations, and collective feelings. Collectiveness within entrepreneurial teams also stands for specific joint entrepreneurial action components in which the structures are constructed. The action components reflect equality and democracy, and open and direct communication in particular. Collectiveness emerges because it is a powerful tool for overcoming individualized barriers to entrepreneurship and due to collectively oriented desire for, collective value orientation to, demand for, and encouragement to team entrepreneurship. Collectiveness emerges and reinforces in processes of joint creation and realization of entrepreneurial opportunities including joint analysis and planning of the opportunities and strategies, decision-making and realization of the opportunities, and evaluation, feedback, and sanctions of entrepreneurial action. Collectiveness matters because it is relevant for potential future entrepreneurs and because it affects the ways collective ventures are initiated and managed. Collectiveness also matters because it is a versatile, dynamic, and malleable phenomenon and the ideas of it can be applied across organizational contexts that require team work in discovering or creating and realizing new opportunities. This study further discusses how the findings add to the existing knowledge of entrepreneurial team literature and how the ideas can be applied in educational, managerial, and policy contexts.

Customer Knowledge Transfer in MNCs

The purpose of this Master’s thesis was to study customer knowledge transfer processes in multinational corporations (MNCs). The main objective was to examine how customer knowledge is transferred in MNCs and what kind of factors enhance or inhibit the knowledge transfer process, and to create a framework on the basis of the existing literature and the empirical findings. In this thesis the factors were organized according to whether they are properties of the unit involved in knowledge management, properties of relationships between the units or properties of the knowledge itself. There are various properties that influence knowledge transfer but in this thesis the focus was on examining the relevant findings from the customer knowledge viewpoint. Empirical results show that internal fragmentation in the MNC seems to be inherent in this type of organization, and may cause many problems in customer knowledge transfer and utilization. These knowledge transfer inhibitors rise from the organization’s properties: it’s absorptive capacity, motivation, organizational culture, and the two dimensions of knowledge. However, in spite of the inherent forces causing internal fragmentation and inhibiting knowledge transfer, moderate customer knowledge and expertise codification, cooperative working practices among the experts, and socialization mechanisms posed by the headquarters seem to help maintain customer knowledge transfer, and value creation in the long-term relationship. This value creation can be seen to be based on accessing and integrating a wide variety of knowledge resources in order to create a coherent product and service offering.

Lean Product Management – Enhancing Product Managers' Ability to Create Value

The purpose of this master’s thesis was to study the opportunity to apply Lean practices to product management function which happens in an office environment. Since product management plays an important role in the company’s success story, it’s important to have it functioning as effectively as possible. The goal was to find those Lean tools and methods that fit the best to the needs of product management. The research was conducted as a qualitative action research which comprises a comprehensive literature review and a single case study. Theoretical information about Lean Thinking and product management was collected from articles, literature and Internet sources. Moreover, empirical data was collected by conducting interviews in the Case Company’s product management department in order to gain an in-depth understanding of product management’s problematics. The results indicate that most of the product management challenges could be overcome by applying Lean practises. Based on the usability rate, which has been discussed in the empirical part of this study, the most suitable Lean practises for product management function are: value stream mapping, Kanban and KPIs.

Hiljaisen tiedon hyödyntäminen verkostoituneen yrityksen ict-ryhmässä

Työn alustavana tavoitteena oli havaita yrityksen ict-ryhmässä käytettävien teknisten välineiden, informaation hallinnan järjestelmien ja ryhmän työtilojen vaikutus hiljasen tiedon jakamiseen tai sen estymiseen. Työssä tarkasteltiin myös vaikutusta ryhmän oppimiseen sekä ryhmään muodostuvan hiljaisen tiedon syntymisen ja henkilöitymisen syihin sekä hiljaisen tiedon laatuun. Lisäksi työssä pyritään löytämään tapoja, joiden avulla hiljaista tietoa voidaan hyödyntää ja jakaa ryhmässä siten että se mahdollistaa myös ryhmän oppimisen. Haastatteluissa nousivat esiin informaation hallintaongelmat, jotka johtuvat informaation hajautumisesta informaation eri hallinta järjestelmiin, tietoturvamääräysten aiheuttamiin esteisiin ja kriittisen teknisen dokumentaation tallentamiseen. Nämä vaikeuttavat tallennetun informaation hyödyntämistä ict-ryhmässä. Tämä osaltaan aiheuttaa hiljaisen tiedon henkilöitymistä ryhmässä ja hiljaisen tiedon jakamisen menetelmien jää hyödyntämättä. Haastatteluissa osoittautui, että hiljaisen tiedon hyödyntämisongelmat johtuvat osittain ryhmän sisäisten yhteyksien verkoston rakenteesta. Vahvojen linkkien vähyys ryhmässä ja vahvojen linkkien suuntautuminen ryhmän ulkoisiin verkostoihin vaikeuttaa hiljaisen tiedon siirtymistä ryhmässä ja aiheuttaa hiljaisen tiedon henkilöitymistä. Kiire todettiin ryhmän kannalta ongelmalliseksi hiljaisen tiedon jakamisen ja hyödyntämisen esteeksi. Tiedon adaptaatioon ja omaksumiseen liittyvät ongelmat ovat sidoksissa aikaan ja hiljaisen tiedon henkilöitymiseen ryhmässä. Ryhmätyö ja ryhmän päivittäisessä toiminnassa käytettävissä olevat hiljaisen tiedon jakamisen menetelmät osoittautuvat sopivimmiksi edistämään ryhmän yhteistyökykyä sekä sosiaalisen rakenteen ja luottamuksen kehittymistä. Ne poistavat myös tiedon omaksumisen ja adaptaation esteitä. Ryhmätyö vaikuttaa myönteisesti ryhmän kollektiiviseen osaamiseen ja ryhmän hiljaisen tiedon kehittymiseen. Lisäksi se parantaa teknisen dokumentaation ymmärrettävyyttä.

BP BLOGGER: DESCRIPTIVE STUDY OF ELECTRONIC KNOWLEDGE DISSEMINATION IN LONG TERM CARE

Little is known of the uptake and use of knowledge disseminated in electronic formats, especially in Long Term Care (LTC) settings. The purpose of this descriptive study was to examine the dissemination of the BP Bloggers, a series of brief, evidence summaries designed to meet the knowledge needs of LTC staff. Guided by Rogers’ (2003) Diffusion of Innovations theory, the study documents dissemination of the BP Blogger and examines factors affecting dissemination, awareness, perceptions and its use. The survey of BP Blogger recipients was conducted electronically (n=114) online (n=10), by telephone (n=55), and print (n=144). Managers usually received the newsletter electronically while staff in LTC were more likely to receive printed copies. Participants disseminated the newsletter through paper, email, or posting in the workplace. Most participants rated the content, format, and usefulness of the BP Blogger as good or excellent. Time and lack of email access were barriers to dissemination.

L’intégration professionnelle : perception des médecins immigrants

RÉSUMÉ : Problématique : En dépit du nombre croissant de médecins immigrants qui choisissent de s’installer au Québec, et de la pénurie de ces professionnels de la santé, beaucoup d’entre eux ne parviendront pas à exercer leur profession au Québec. Les études réalisées auparavant n’étaient souvent pas spécifiques à l’intégration professionnelle des médecins immigrants au Québec. Et de nouvelles barrières émergeaient à chaque étude, justifiant la nécessité d’une démarche exploratoire pour mieux comprendre le sujet. Objectifs : L’objectif de cette étude est d’identifier et analyser les barrières à l’intégration professionnelle ainsi que les facteurs facilitants perçus par les médecins immigrants diplômés hors Canada et États-Unis qui choisissent de s’installer au Québec. Méthodologie : La stratégie retenue est la recherche synthétique de type étude de cas. C’est une recherche qualitative principalement basée sur l’analyse de 22 entrevues semi-structurées, réalisées avec des médecins immigrants diplômés hors Canada et États-Unis, originaires de 15 pays différents. L’échantillon est de type variation maximale, selon le pays d’origine, la formation initiale, l’expérience professionnelle et selon le parcours personnel au Québec. Le recrutement a été réalisé principalement à l’aide de la collaboration du Centre d'évaluation des sciences de la santé de l’Université Laval, de l’organisme « l’Hirondelle » et du département d’administration de la santé de l’Université de Montréal. Le cadre théorique est celui de Diaz (1993) et les différents thèmes qui ont été abordés dans l’entrevue sont inspirés de la synthèse des barrières et des perceptions citées dans la littérature dont la plupart ne sont pas spécifiques aux médecins immigrants. Ces thèmes généraux sont représentés par les contraintes linguistiques, socioculturelles, informationnelles, financières, procédurales et discriminatoires. Pour ce qui est des thèmes des facteurs facilitants, ce sont : les facteurs financiers, informationnels, d’aide et de support à l’intégration professionnelle. Résultats : Les 22 participants étaient composés de 13 hommes et de 9 femmes, âgés de 29 à 53 ans, originaires de 15 pays différents et ayant une durée de séjour au Québec de 2 à 15 ans. Lors des entrevues, les émergences recueillies grâce aux questions ouvertes ont permis d’appréhender les difficultés spécifiques perçues par les médecins immigrants qui n’ont pas été soulevées ii par la littérature. Les barrières à l’intégration professionnelle perçues par les médecins immigrants sont surtout de nature procédurale, mais également institutionnelles, et dans une moindre mesure, socioculturelles. Les principales barrières procédurales sont relatives aux facteurs informationnels, à l’évaluation des connaissances et des compétences médicales, mais surtout à l’absence de garantie de l’octroi des postes de résidence même après la réussite des examens exigés. Les facteurs facilitants les plus importants sont l’harmonisation des procédures provinciales et fédérales, l’amélioration relative de l’information, le soutien linguistique pour les nonfrancophones et la pénurie des médecins. Conclusion : La réduction des nombreuses barrières identifiées dans cette recherche, permettra non seulement de faciliter l’intégration professionnelle des médecins immigrants, mais également de contribuer à réduire la pénurie de ces professionnels de la santé au Québec.

Access to care for the poor living with chronic disease in India : an analysis of selected national health policies

Cette recherche sur les barrières à l’accès pour les pauvres atteints de maladies chroniques en Inde a trois objectifs : 1) évaluer si les buts, les objectifs, les instruments et la population visée, tels qu'ils sont formulés dans les politiques nationales actuelles de santé en Inde, permettent de répondre aux principales barrières à l’accès pour les pauvres atteints de maladies chroniques; 2) évaluer les types de leviers et les instruments identifiés par les politiques nationales de santé en Inde pour éliminer ces barrières à l’accès; 3) et évaluer si ces politiques se sont améliorées avec le temps à l’égard de l’offre de soins à la population pour les maladies chroniques et plus spécifiquement chez les pauvres. En utilisant le Framework Approach de Ritchie et Spencer (1993), une analyse qualitative de contenu a été complétée avec des politiques nationales de santé indiennes. Pour commencer, un cadre conceptuel sur les barrières à l’accès aux soins pour les pauvres atteints de maladies chroniques en Inde a été créé à partir d’une revue de la littérature scientifique. Par la suite, les politiques ont été échantillonnées en Inde en 2009. Un cadre thématique et un index ont été générés afin de construire les outils d’analyse et codifier le contenu. Finalement, les analyses ont été effectuées en utilisant cet index, en plus de chartes, de maps, d'une grille de questions et d'études de cas. L’analyse a tété effectuée en comparant les barrières à l’accès qui avaient été originalement identifiées dans le cadre thématique avec celles identifiées par l’analyse de contenu de chaque politique. Cette recherche met en évidence que les politiques nationales de santé indiennes s’attaquent à un certain nombre de barrières à l’accès pour les pauvres, notamment en ce qui a trait à l’amélioration des services de santé dans le secteur public, l’amélioration des connaissances de la population et l’augmentation de certaines interventions sur les maladies chroniques. D’un autre côté, les barrières à l’accès reliées aux coûts du traitement des maladies chroniques, le fait que les soins de santé primaires ne soient pas abordables pour beaucoup d’individus et la capacité des gens de payer sont, parmi les barrières à l'accès identifiées dans le cadre thématique, celles qui ont reçu le moins d’attention. De plus, lorsque l’on observe le temps de formulation de chaque politique, il semble que les efforts pour augmenter les interventions et l’offre de soins pour les maladies chroniques physiques soient plus récents. De plus, les pauvres ne sont pas ciblés par les actions reliées aux maladies chroniques. Le risque de les marginaliser davantage est important avec la transition économique, démographique et épidémiologique qui transforme actuellement le pays et la demande des services de santé.

Facteurs liés à l’adoption du dossier médical électronique (DME): une étude de cas sur le processus d'implantation d’un DME dans un groupe de médecine de famille.

Dans l’espoir d'améliorer l'efficacité, l’efficience, la qualité et la sécurité des soins de santé, la plupart des pays investissent dans l’informatisation de leur système de santé. Malgré l’octroi de ressources substantielles, les projets d'implantation d’un Dossier médical électronique (DME) font parfois l’objet d’une résistance importante de la part des utilisateurs au moment de leur implantation sur le terrain. Pour expliquer l’adoption d’un DME par les professionnels de la santé, plusieurs modèles théoriques ont été développés et appliqués. Une diversité de facteurs agissant à différents niveaux (individuel, organisationnel et liés à la technologie elle-même) a ainsi été identifiée. L’objectif de cette recherche est d’approfondir les connaissances empiriques quant aux facteurs influençant l’utilisation du DME chez les professionnels de la santé. Le devis de recherche repose sur une étude de cas unique avec douze entrevues et une observation non participante réalisées un an suite au lancement du processus d’implantation d’un DME auprès d’un groupe de médecine famille (GMF) au sein du Centre de santé et de services sociaux du Sud-Ouest-Verdun (Montréal, Canada). Dans le cadre de cette étude, l’analyse a permis l’identification de facilitateurs et de barrières influençant l’adoption du DME. Les facilitateurs étaient l’utilité perçue, la décision du GMF d’implanter le DME, le support de la direction ainsi que la présence de champions et de superutilisateurs. Les barrières les plus importantes étaient l’impact négatif sur le travail clinique, la fragmentation de l’information dans le DME ainsi que les problèmes liés à l’infrastructure technique. Cette connaissance permettra d’alimenter des stratégies visant à mieux répondre aux défis suscités par l’implantation du dossier médical électronique.