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Exploring Tampering: Towards an Understanding of Why Improvement Efforts Sometimes Fail
Linköping University, Department of Management and Engineering, Logistics & Quality Management. Linköping University, Faculty of Science & Engineering.ORCID iD: 0000-0001-6855-0664
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Ever-increasing competition together with increasing and changing customer demands place high demands on organisations to maintain and improve their current products and services while also developing and renewing their offerings. However, research claims that many improvement efforts carried out in organisations fail. A line of research in quality management focusing on process improvement proposes that tampering, i.e. attempts to solve problems without targeting the fundamental causes of the problem, may be one reason why some attempts to improve fail. This dissertation focuses on faulty identification of causes of problems, as well as responses to such problems made by individual employees in their day-today work.

The purpose of this dissertation is to enhance knowledge on tampering as a means to understand why attempts to improve sometimes do not lead to the desired results. This dissertation also answers the research questions How is tampering manifested in various types of approaches to identifying and responding to problems? and How can customers cause employees to take tampering actions? Studying how tampering is manifested in different ways depending on how a problem is interpreted and consequently the approach taken to respond to the problem can enhance knowledge about which interpretations and actions may lead to tampering. In this dissertation, approaches are viewed as alternative courses of actions available to employees when responding to problems. Four different types of approaches are studied: inaction, workaround, local improvement and system change. In addition, possible connections between customers and tampering are discussed and in this dissertation, it is proposed that the customer may have a negative impact on employees’ improvement efforts. In addition to answering the two research questions, a contemporary understanding of the tampering concept is proposed.

Three studies have been conducted: a narrative literature review, a qualitative interview study and a case study with data collection through interviews, observations and a document study. This dissertation includes five appended papers. To answer the first research question, the main findings from the papers have been analysed by applying flexible pattern matching. The flexible pattern matching process was conducted by developing a theoretical framework of approaches, summarising the findings from the papers, and then comparing the findings to the theoretical framework to identify similarities and differences. To answer the second research question, examples of tampering were studied where the customer affected which problem was to be remedied or how.

The analysis in the first research question results in five manifestations of tampering in various approaches to identifying and responding to problems. Actions proposed to cause tampering are passivity/wait-and-see, symptomatic response, locally focused response, disproportionate vision and vicious spiral of firefighting. The analysis in the second research question shows multiple examples of customer-induced tampering. Customers do not tamper with an organisation’s processes, but may express demands or concerns about perceived problems or how to execute a process that the organisation complies with. The saying ‘the customer is always right’ seems to be applied especially when the demand is placed by customers who are considered particularly important for relational or economic reasons.

This dissertation contributes to research on quality management in general and improvement efforts through employees approaches as well as the customers role in identifying and responding to problems in particular. This dissertation and the appended papers explore the concept of tampering, and suggest that there is a need for a revitalisation and a broader understanding of the concept in order to increase its applicability in contemporary contexts. This dissertation also explores the previously under-explored

perspective on how customers can cause organisations to take measures that – from a process perspective – create process deterioration.

Abstract [sv]

Till följd av den ständigt ökande konkurrensen samt de ökande och förändrade kundkraven är förbättring en central aspekt för organisationer för att underhålla och förbättra nuvarande produkter och tjänster samt att utveckla och förnya sina erbjudanden. Forskningen hävdar dock att många ansträngningar som görs i organisationer för att skapa förbättring misslyckas. En forskningsgren inom kvalitetsutveckling som fokuserar på processförbättring föreslår att tampering (sv. överstyrning), dvs försök att lösa problem utan att försöka påverka de underliggande rotorsakerna till problemet, kan vara en anledning till att försök att skapa förbättring misslyckas. Denna doktorsavhandling fokuserar på enskilda medarbetares bristande identifiering av rotorsaker till problem samt bristfälliga tillvägagångssätt för att agera på sådana problem i deras dagliga arbete.

Syftet med denna avhandling är to enhance knowledge on tampering as a means to understand why attempts to improve sometimes do not lead to the desired results. Denna avhandling besvarar också forskningsfrågorna How is tampering manifested in various types of approaches to identifying and responding to problems? och How can customers cause employees to take tampering actions? Att studera om tampering manifesteras på olika sätt beroende på hur ett problem identifieras och valt tillvägagångssätt för att agera på problemet kan öka kunskapen om vilka tolkningar och åtgärder som kan leda till tampering. Med olika tillvägagångssätt menas olika alternativa åtgärder som är tillgängliga för individer när de agerar på ett problem. Fyra olika typer av tillvägagångssätt studeras: inaktivitet, kringgående, lokal förbättring och systemförändring. Dessutom diskuteras möjliga kopplingar mellan kunden och överstyrning då denna avhandling föreslår att kunden kan ha en negativ inverkan på medarbetarnas förbättringsarbete. Förutom att besvara de två forskningsfrågorna, föreslås även en samtida förståelse av begreppet tampering i denna kappa.

Tre studier har genomförts: en narrativ litteraturöversikt, en kvalitativ intervjustudie och en fallstudie med datainsamling genom intervjuer, observationer samt dokumentstudie. Den huvudsakliga analysen genomfördes genom att utveckla ett konceptuellt ramverk bestående av olika tillvägagångsätt, sammanfatta resultaten från de bifogade artiklarna och jämföra resultaten med ramverket för att hitta likheter och skillnader. Dessutom analyserades överstyrningsexempel där kunden influerat vilket problem som ska åtgärdas eller hur.

Analysen resulterar i fem manifestationer av tampering. Tillvägagångssätt som föreslås orsaka överstyrning är: passivitet/vänta-och-se, symtomatiska åtgärder, lokalt fokuserade åtgärder, oproportionerliga visioner av åtgärder och ond spiral av brandsläckning. Analysen visar flera exempel på kundinducerad överstyrning. Kunderna överstyr inte nödvändigtvis en organisations processer, utan uttrycker åsikter eller oro kring upplevda problem eller hur man genomför en process som medarbetarna tillämpar. Ordspråket ’kunden har alltid rätt’ verkar särskilt tillämpas när krav ställs av kunder vilka anses särskilt viktiga av relationella eller ekonomiska skäl.

Denna avhandling bidrar till forskning om kvalitetsutveckling i allmänhet och förbättringsarbete genom individens tillvägagångssätt samt kundens roll i att identifiera och agera på problem i synnerhet. Denna avhandling och dess bifogade artiklar utforskar begreppet tampering och antyder att det finns ett behov av att förnya och skapa en bredare förståelse av begreppet för att öka tillämpbarheten i en samtida kontext. Denna avhandling utforskar också det tidigare underutforskade perspektivet om hur kunder kan påverka medarbetare att vidta åtgärder som ur ett processperspektiv leder till processförsämringar.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2022. , p. 77
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 2213
National Category
Reliability and Maintenance
Identifiers
URN: urn:nbn:se:liu:diva-183125DOI: 10.3384/9789179292379ISBN: 9789179292362 (print)ISBN: 9789179292379 (electronic)OAI: oai:DiVA.org:liu-183125DiVA, id: diva2:1639821
Public defence
2022-03-25, ACAS, A Building, Campus Valla, Linköping, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2022-02-22 Created: 2022-02-22 Last updated: 2022-09-01Bibliographically approved
List of papers
1. Deming's tampering revisited: definition and future research agenda
Open this publication in new window or tab >>Deming's tampering revisited: definition and future research agenda
2022 (English)In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703, Vol. 14, no 5, p. 37-51Article, review/survey (Refereed) Published
Abstract [en]

Purpose How do organisations know which problems are worthy of their attention? Despite good intentions, many attempts to solve problems fail. One reason for this failure might be because of attempts to solve non-problems or to solve problems with insufficient means, a concept proposed by Deming as tampering. The purpose of this paper is to suggest a definition of tampering, outline what is currently known about possible practical implications of tampering and to suggest how to extend this knowledge by proposing an agenda for future research. Design/methodology/approach To fulfil the purpose, a narrative literature review was conducted. Findings Through this review, common aspects of what constitutes tampering are identified and the following definition is proposed: Tampering is a response to a perceived problem in the form of an action that is not directed at the fundamental cause of the problem, which leads to a deterioration of the process or the process output. In addition, recommendations are generated regarding how tampering manifests itself in practice and why tampering occurs. These recommendations could be studied in future research. Originality/value To the best of the authors knowledge, this is the first paper that suggests a revitalisation of tampering. The results presented in this paper form the basis for continued studies on how tampering in organisations can be understood, managed and prevented.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2022
Keywords
Behaviour; Quality management; Literature review; Variation; Problem-solving and decision-making
National Category
Business Administration
Identifiers
urn:nbn:se:liu:diva-182013 (URN)10.1108/IJQSS-03-2021-0041 (DOI)000730691600001 ()2-s2.0-85121294546 (Scopus ID)
Available from: 2022-01-03 Created: 2022-01-03 Last updated: 2022-02-22
2. The effects of cancer care pathways on waiting times
Open this publication in new window or tab >>The effects of cancer care pathways on waiting times
2019 (English)In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703, Vol. 11, no 2, p. 204-216Article in journal (Refereed) Published
Abstract [en]

Purpose

The Swedish health-care system currently implements cancer care pathways (CCPs) for better and more timely cancer diagnostics. The purpose of this paper is to elucidate and define “crowding out” effects associated with the CCP implementation.

Design/methodology/approach

A document study based on implementation reports and action plans from Swedish county councils (n = 21) and a case study in one county council were conducted. Qualitative data collection and analysis were used to acquire more knowledge about the “crowding out” effects associated with the CCP implementation.

Findings

Three effects discussed under “crowding out” were defined. The first effect, called the push-out effect, occurs when other patients have to wait for care longer in favour of CCP patients. Another effect is the inclusion effect, whereby “crowding out” is reduced for vulnerable patients due to the standardised procedures and criteria in the referral process. The final effect is the exclusion effect, where patients in need of cancer diagnostics are, for some reason, not referred to CCP. These patients are either not diagnosed at all or diagnosed outside CCP by a non-standard process, with the risk of longer waiting times.

Originality/value

“Crowding out” effects are an urgent topic related to CCP implementation. While these effects have been reported in international research studies, no shared definition has been established to describe them. The present paper creates a common base to measure the “crowding out” effects and support further development of CCPs to avoid the negative effects on waiting times.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2019
Keywords
Health care, Standardisation, Patient care, Quality management, Health care management, Quality of health care
National Category
Reliability and Maintenance Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-154049 (URN)10.1108/IJQSS-04-2018-0041 (DOI)000479227600004 ()2-s2.0-85058658565 (Scopus ID)
Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2022-03-04Bibliographically approved
3. Why won’t you leave the process alone?: Exploring emotional, motivational and cognitive mechanisms triggering tampering
Open this publication in new window or tab >>Why won’t you leave the process alone?: Exploring emotional, motivational and cognitive mechanisms triggering tampering
2023 (English)In: Total Quality Management and Business Excellence, ISSN 1478-3363, E-ISSN 1478-3371, Vol. 34, no 5-6, p. 791-805Article in journal (Refereed) Published
Abstract [en]

Quality management focuses on improvements aimed at enhancing the value createdfor various stakeholders. However, actions taken in response to a perceived problemsometimes lead to an inferior result rather than an improvement. Such actions havebeen denoted tampering. As an example, natural variation might unnecessarily beperceived as a problem, where the best way to handle that ‘problem’ would be to notact at all. However, for someone trained in quality management and striving forimprovement, doing nothing might be more challenging than acting. The researchquestion studied in this paper is: How do emotional, motivational and cognitivemechanisms influence tampering in problem-solving situations? Through interviewswith 17 respondents, 33 tampering situations were identified and analysed. Thefindings describe emotional, motivational and cognitive mechanisms that leadindividuals to take actions leading to tampering. Some examples of thesemechanisms are fear of the consequences of not acting, feelings of guilt if not actingto resolve a problem, and taking actions based on experiences of past problemsolving. To counteract this, it is advised to set aside time for reflections beforestarting problem-solving and to establish an environment encouraging of reflections.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
tampering; motivation; emotion; cognition; variation; quality management
National Category
Work Sciences
Identifiers
urn:nbn:se:liu:diva-187990 (URN)10.1080/14783363.2022.2112514 (DOI)000843897000001 ()
Note

Funding agency: HELIX Competence Centre at Linköping University

Available from: 2022-09-01 Created: 2022-09-01 Last updated: 2023-11-21Bibliographically approved

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