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  • 1.
    Hansson, Lisa
    et al.
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Weinholt, Åsa
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Collaborative practices at local government level: examples from the emergency service sector2014Conference paper (Other academic)
  • 2.
    Hansson, Lisa
    et al.
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Weinholt, Åsa
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Front-line Staff Collaboration: Adaptation to New Practices within the Fire and Rescue ServiceManuscript (preprint) (Other academic)
    Abstract [en]

    This paper analyses collaborative practice within the fire and rescue services (FRS), with the aim to describe how the FRS adapt to a collaborative service delivery and to provide a theoretical understanding of the new type of actors emerging in such context. The findings are based on three collaborative cases. The data consist of public documents, interviews, and incident reports. The findings show that FRS does not adapt to a collaborative setting, instead the adjustment is made by the new actors. Discretion, professional identity, and personal motivation are factors related to understanding the new front-line actors that emerge within this context.

  • 3.
    Svensson, Anders
    et al.
    Linnéuniversitetet.
    Weinholt, Åsa
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    När hemsjukvården lämnar hemmet: En analys av sambruk på Öckerö när kommunens sjuksköterskor biträder räddningstjänsten vid akuta vårdlarm i väntan på ambulans2014Report (Other academic)
    Abstract [sv]

    Den här rapporten beskriver hur Öckerö kommun har arbetat med sambruk av kommunens jour- och beredskapsresurser för att kunna erbjuda kommuninvånarna bättre service i händelse av en olycka eller allvarlig händelse. Rapporten belyser det nystartade projektet IVPA samt biträde av kommunens sjuksköterska som innebär att hemsjukvårdens sjuksköterska bistår räddningstjänsten med medicinsk kompetens i väntan på ambulans (IVPA).

    Studiens syfte var att utreda åtgärden utifrån två perspektiv; sjuksköterskornas upplevelse av projektet samt projektets samhällsekonomiska nyttor respektive kostnader. I uppdraget ingick att ta del av tidigare studier inom området samt att utföra intervjuer med ett urval av sjuksköterskorna i kommunen samt med berörda chefer.

    Sjuksköterskorna upplever att införandet av IVPA och de nya rutinerna vid förändringen gör gränserna för deras arbetsuppgifter otydliga. De beskriver en rollförvirring och ger uttryck för att det inte funnits förutsättningar att utföra uppdraget till fullo. Sjuksköterskorna ser en svårighet i att sammanföra IVPA med deras ordinarie arbetssätt då detta inte upplevs förenligt med premisserna av att vara ”stand by”, släppa det man har för händer och åka på nya uppdrag. Känslor av att tvingas prioritera mellan ”sina” egna och IVPA patienter samt att svika en väntande patient leder till skuldkänslor. Trots att adekvata förberedelser avdramatiserat uppdraget tänker de det värsta och skräms av tanken på att känna patienten. Sjuksköterskorna ger även uttryck för en känsla av att inte räcka till och en rädsla för att bli ifrågasatt vid IVPA uppdrag. Samtidigt känner de sig överflödiga och att inte vara till nytta då det ofta är en fördröjd utlarmning. Väl på plats känner de ett stöd i räddningstjänstens vana av situationen och att deras kunskap ses som ett komplement. De känner dock ingen grupptillhörighet och saknar möjlighet till samtal med inblandade aktörer efter händelsen. Förutom samtal och återkoppling beskriver sjuksköterskorna även ett behov av stöd grundat i ansvaret av att vara ensam om svåra beslut.

    Idag går det inte att dra några slutsatser om sambruksprojektet är samhällsekonomiskt lönsamt. Om vi utgår från de tre uppdrag där sköterskorna hittills har deltagit skulle vi komma fram till att projektet inte har varit samhällsekonomiskt lönsamt. Däremot har projektet pågått kort tid och det är många bitar som inte har fallit på plats ännu. Idag finns det exempelvis två flaskhalsar som gör att sköterskan inte anländer i tid. Det ena är att rutinen för när sköterskan ska åka gör att det dröjer för lång tid innan de kommer iväg. Det andra är att sköterskorna (och räddningstjänsten) larmas senare från larmcentralen än ambulansen vid IVPA-uppdrag. Ytterligare en förutsättning för att projektet ska ge maximal nyttoeffekt är att låta sköterskan åka på larm även kvällar och nätter, då skulle en större andel av de totala IVPA-uppdragen på Öckerö fångas upp. En annan lösning är att låta fler sköterskor ha IVPA-uppdrag; ju fler sköterskor som har IVPA-uppdrag desto högre blir nyttan, eftersom insatstiderna då kan förkortas. Detta kräver dock mer avancerade kommunikationsverktyg. Skulle en sjuksköterska exempelvis haft möjlighet att rädda ett liv via IVPA-uppdraget som  annars hade gått förlorat (vilket i samhällsekonomiska kalkyler värderas till cirka 23 miljoner kronor) så skulle nyttan med sambruksprojektet antagligen vida överstiga kostnaderna. De största identifierade kostnadsposterna i projektet är investeringskostnader för kläder och materiel, driftkostnader för bil samt utbildningskostnader. Däremot finns det flera osäkra kostnader som idag är svåra att  bedöma, varav en av de viktigaste är de som kan uppstå om IVPA-verksamheten påverkar vården för patienterna i ordinarie verksamhet negativt. För att på sikt kunna utvärdera denna och liknande förändringar med hjälp av kostnads-nyttoanalys har rekommendationer för dokumentation tagits fram.

  • 4.
    Weinholt, Åsa
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Andersson Granberg, Tobias
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    En samhällsekonomisk utvärdering av samarbete mellan räddningstjänst och väktare2013Report (Other academic)
    Abstract [sv]

    Antalet förstainsatsaktörer i Sverige idag utanför de traditionella (räddningstjänst, polis och ambulans) är få, och lite forskning har förts på området. Det finns dock exempel där räddningstjänsten har anlitat väktarbolag eller utrustat hemtjänstpersonal med pulversläckare. Flertalet av dessa samarbeten är relativt nystartade och få utvärderingar har gjorts som visar de faktiska effekterna av dem. Syftet med denna rapport är att beskriva och kartlägga samhällekonomiska nyttor och kostnader av icke-traditionella förstainsatsaktörer som samarbetar med räddningstjänsten.

    Studien har genomförts genom fallstudier av två samarbeten; Söderköping räddningstjänst som har ett avtal med LA Jour & Säkerhet AB samt Södertörns brandförsvarsförbund (SBBF) som samarbetar med väktarbolag i Södertälje och Botkyrka. Sju semistrukturerade intervjuer har genomförts med representanter från väktarbolag, räddningstjänst och kommun. Den metod som används vid analysen är nationalekonomisk kostnadsnyttoanalys.

    De nyttor som har identifierats är att väktarna sparar tid, bidrar med lägesrapporter, stöttar insatserna genom att vara behjälpliga på plats, upptäcker incidenter eller bränder vid rondering. De har god lokalkännedom och kan hjälpa till att låsa upp brandbommar och dörrar, vilket indirekt sparar tid åt räddningstjänsten. Samarbetet bidrar också till att de arbetar preventivt; de pratar med ungdomar och andra grupper i samhället och skapar relationer som på sikt har möjlighet att gagna säkerheten och tryggheten i kommunen.

    Kostnaderna för att utbilda och utrusta väktarna är idag låga. Däremot har det framkommit att väktarna gärna skulle vilja ha mer utbildning så att de kan rycka ut vid fler typer av larm. Det har även framkommit att bättre kommunikationskanaler skulle kunna bidra till ökade möjligheter att åka på fler larm och att vara bättre förberedda på vad de kan bidra med vid olika typer av larm.

    Den kvantitativa analysen utförs för samarbetet i Söderköping och visar att detta har en hög utdelning. Varje investerad krona i Söderköping har gett en avkastning på åtta kronor, när värdet av den minskade insatstid som väktarna bidrar med beräknas. Nyttan är dock undervärderad då många nyttor (beskrivna ovan) inte kan värdesättas monetärt.

    Det som har begränsat den kvantitativa analysen är det faktum att väktarnas rapportering i Botkyrka och Södertälje inte särskiljer räddningstjänstsuppdrag från övriga uppdrag. Detta hade möjliggjort en kvantitativ analys även för samarbetet med Södertörn, vilket hade kunnat bidra till att resultaten blivit applicerbara på fler kommuner. Emellertid finns inget som indikerar att andra kommuner inte kommer att erfara samma effekter eller kostnader som de undersökta samarbetena har lett till. Däremot bör kommuner analysera behov och förutsättningar i sin kommun för samarbeten av det här slaget innan de inför dem med tanke på att det uppstår kostnader, om än låga.

  • 5.
    Weinholt, Åsa
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Andersson Granberg, Tobias
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Evaluation of enhanced collaboration between fire and rescue servicesand security officers2013In: Proceedings of the 10th International ISCRAM Conference / [ed] T. Comes, F. Fiedrich, S. Fortier, J. Geldermann, T. Müller, 2013, p. 735-740Conference paper (Refereed)
    Abstract [en]

    The hypothesis of this study is that collaboration between fire and rescue services and new actors, with basic rescue skills, might be a cost effective way to improve emergency response. Interview studies of collaborations between fire and rescue services and security officers in three Swedish municipalities are presented. Seven semi-structured interviews are conducted with representatives from the security officer companies, the fire and rescue services and security managers at the municipalities. The method used to evaluate the collaborations quantitatively is Cost-benefit analysis. The collaborations have positive economic effects for society that most likely outweighs the costs. There also exist several external effects that are not possible to value monetarily, but that represent positive values for society. The results and their generalizability are discussed, as well as the possibility for these new collaborations to improve crisis management.

  • 6.
    Weinholt, Åsa
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Andersson, Tobias
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    New collaborations in daily emergency response: Applying cost benefit analysis to new first response initiatives in the Swedish fire and rescue service2015In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 4, no 2, p. 177-193Article in journal (Refereed)
    Abstract [en]

    Purpose

    – The purpose of this paper is to analyse costs and benefits from new collaborations in daily emergency response and to demonstrate how cost-benefit analysis (CBA) can be used for evaluating effects from these kinds of collaborations.

    Design/methodology/approach

    – CBA is used to evaluate two collaborations. The cases are: security officers that respond to fire and rescue service (FRS) calls; and home care nurses that assist the FRSs when they respond to urgent medical calls. Interviews, public documents and incident reports have been used as sources of data.

    Findings

    – Most costs are relatively straightforward to estimate. More difficult to estimate are the turn-out costs, including the services that cannot be performed when the new actors take on new assignments. One important benefit from these kinds of collaborations is reduced response time. Other benefits include increased situational awareness and improved preventive work in Case 1, as well as improved working conditions for the traditional resources and increased medical competence in Case 2. The analysis indicate that the case with the security officers most likely was socially beneficial, while the case with the home care nurses at the time of the study was not.

    Originality/value

    – The authors provide a thorough description and analysis of two interesting new ways of performing daily emergency response. Furthermore, the authors depict how CBA can be used to structure the analysis and evaluation of new initiatives in emergence services and how it can be used for identifying improvement potential. The authors also identify and discuss what is needed in terms of documentation as well as research, for it to be possible to improve the quantitative analysis of these kinds of initiatives

  • 7.
    Weinholt, Åsa
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Holmgren, Johan
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Evaluating the effects of organizational changes and private sector involvement on cost efficiency in fire and rescue services2014Conference paper (Other academic)
  • 8.
    Weinholt, Åsa
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Holmgren, Johan
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    The Influence of Organizational Changes on Cost Efficiency in Fire and Rescue ServicesManuscript (preprint) (Other academic)
    Abstract [en]

    Fire and rescue services in Sweden have recently undergone organizational changes aiming at improving service quality and efficiency. Among those changes are an increased number of formalized cooperations between FRSs in neighboring municipalities, increased collaboration with other sectors in day-to-day operations, changes in the structure of rescue teams, and an increase in the tasks performed by the services. The purpose of this study was to evaluate whether these policy changes have resulted in increased cost efficiency in the Swedish FRS. We used stochastic frontier analysis of annual data from 2009 to 2012 for 205 Swedish municipalities, taking into account the relevant differences in conditions among them. The conclusion is that there is no evidence to be found of improved efficiency in the FRS. The policy changes that have been implemented have not had the desired effects, and most of the policy variables tested for inclusion in the model were not found significant. Recommendations for future research are to further investigate why these policy changes have not yet given the expected results, to examine how and if collaboration with different types of organizations (public, private and non-profit) affects efficiency differently and to make further in-depth comparisons between the most efficient and least efficient FRSs for there are great variations between them.

  • 9.
    Åsa, Weinholt
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Exploring Collaboration Between the Fire and Rescue Service and New Actors: Cost-efficiency and Adaptation2015Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The emergency services serves an important purpose in society by ensuring that people in need, regardless of their geographical location, receives help when they fall victims to undesirable incidents. Existing resources are however often limited and concentrated to urban areas making travel distances to remote areas long. Local authorities are also facing budget constraints and clients are becoming more demanding. This means that the emergency services need to do more, but with less resources. Collaboration with new actors has therefore been proposed as a solution. There exist several actors with basic knowledge in both fire suppression or medical treatment that might be able to contribute at an early stage in order to reduce response time and provide help to citizens in need. However, little research has been dedicated to investigating the possibilities and the potential of new collaborative practices in every day accidents.

    In this thesis collaboration between new actors and the fire and rescue service (FRS) in Sweden is studied. The aim is to analyze whether collaborative practices leads to an increased cost-efficiency, for the FRS and society as a whole. The thesis also aims to analyze how traditional actors and new actors adapt to collaborative practices.

    For evaluating cost-efficiency in the FRS stochastic frontier analysis is used and for analyzing the societal effects cost-benefit analysis is applied. In total three cases are studied; (1) security officers assisting the FRS in fire alarms (2) home care nurses collaborating with the FRS in medical alarms and (3) citizens responding to FRS-alarms through SMS.

    The results do not show that collaboration have led to increased cost-efficiency in the FRS during the studied time period. However, despite that no evidence for increased cost-efficiency is found in the FRS, there are several societal gains from collaborating related to e.g. equity, quality and effectiveness. And the costs for implementing collaborative arrangements are relatively low. It is however argued that to be able to get the most out of collaboration more emphasis should be put on building common platforms, where the different organizations and actors can communicate, share experiences, organize joint training sessions and actually collaborate. Today interaction outside the rescue site hardly exist between the collaborative partners; the actual collaboration between the FRS and the new actors is limited only to the response phase. Also, the FRS do not adapt their bureaucratic structures to collaborate with the new actors. Instead the changes associated with collaboration affect mainly the new actors, as an addition to their regular duties. Factors related to discretion, professional identity and personal motivation are identified as important for understanding how new actors adapt to collaboration.

    List of papers
    1. The Influence of Organizational Changes on Cost Efficiency in Fire and Rescue Services
    Open this publication in new window or tab >>The Influence of Organizational Changes on Cost Efficiency in Fire and Rescue Services
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Fire and rescue services in Sweden have recently undergone organizational changes aiming at improving service quality and efficiency. Among those changes are an increased number of formalized cooperations between FRSs in neighboring municipalities, increased collaboration with other sectors in day-to-day operations, changes in the structure of rescue teams, and an increase in the tasks performed by the services. The purpose of this study was to evaluate whether these policy changes have resulted in increased cost efficiency in the Swedish FRS. We used stochastic frontier analysis of annual data from 2009 to 2012 for 205 Swedish municipalities, taking into account the relevant differences in conditions among them. The conclusion is that there is no evidence to be found of improved efficiency in the FRS. The policy changes that have been implemented have not had the desired effects, and most of the policy variables tested for inclusion in the model were not found significant. Recommendations for future research are to further investigate why these policy changes have not yet given the expected results, to examine how and if collaboration with different types of organizations (public, private and non-profit) affects efficiency differently and to make further in-depth comparisons between the most efficient and least efficient FRSs for there are great variations between them.

    Keywords
    Fire and rescue services, Stochastic frontier analysis, Efficiency evaluation, Benchmarking
    National Category
    Communication Studies Transport Systems and Logistics
    Identifiers
    urn:nbn:se:liu:diva-115797 (URN)
    Available from: 2015-03-20 Created: 2015-03-20 Last updated: 2015-03-20Bibliographically approved
    2. New collaborations in daily emergency response: Applying cost benefit analysis to new first response initiatives in the Swedish fire and rescue service
    Open this publication in new window or tab >>New collaborations in daily emergency response: Applying cost benefit analysis to new first response initiatives in the Swedish fire and rescue service
    2015 (English)In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 4, no 2, p. 177-193Article in journal (Refereed) Published
    Abstract [en]

    Purpose

    – The purpose of this paper is to analyse costs and benefits from new collaborations in daily emergency response and to demonstrate how cost-benefit analysis (CBA) can be used for evaluating effects from these kinds of collaborations.

    Design/methodology/approach

    – CBA is used to evaluate two collaborations. The cases are: security officers that respond to fire and rescue service (FRS) calls; and home care nurses that assist the FRSs when they respond to urgent medical calls. Interviews, public documents and incident reports have been used as sources of data.

    Findings

    – Most costs are relatively straightforward to estimate. More difficult to estimate are the turn-out costs, including the services that cannot be performed when the new actors take on new assignments. One important benefit from these kinds of collaborations is reduced response time. Other benefits include increased situational awareness and improved preventive work in Case 1, as well as improved working conditions for the traditional resources and increased medical competence in Case 2. The analysis indicate that the case with the security officers most likely was socially beneficial, while the case with the home care nurses at the time of the study was not.

    Originality/value

    – The authors provide a thorough description and analysis of two interesting new ways of performing daily emergency response. Furthermore, the authors depict how CBA can be used to structure the analysis and evaluation of new initiatives in emergence services and how it can be used for identifying improvement potential. The authors also identify and discuss what is needed in terms of documentation as well as research, for it to be possible to improve the quantitative analysis of these kinds of initiatives

    Place, publisher, year, edition, pages
    Emerald Group Publishing Limited, 2015
    Keywords
    Cost-benefit analysis, emergency services, first responders, fire and rescue services, economic evaluation, cost-efficiency
    National Category
    Communication Studies Transport Systems and Logistics
    Identifiers
    urn:nbn:se:liu:diva-115798 (URN)10.1108/IJES-01-2015-0002 (DOI)
    Funder
    Swedish Civil Contingencies Agency
    Note

    The status of this article was previously Manuscript.

    Available from: 2015-03-20 Created: 2015-03-20 Last updated: 2017-12-04Bibliographically approved
    3. Front-line Staff Collaboration: Adaptation to New Practices within the Fire and Rescue Service
    Open this publication in new window or tab >>Front-line Staff Collaboration: Adaptation to New Practices within the Fire and Rescue Service
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    This paper analyses collaborative practice within the fire and rescue services (FRS), with the aim to describe how the FRS adapt to a collaborative service delivery and to provide a theoretical understanding of the new type of actors emerging in such context. The findings are based on three collaborative cases. The data consist of public documents, interviews, and incident reports. The findings show that FRS does not adapt to a collaborative setting, instead the adjustment is made by the new actors. Discretion, professional identity, and personal motivation are factors related to understanding the new front-line actors that emerge within this context.

    Keywords
    Front-line staff, collaboration, local government, fire and rescue services
    National Category
    Communication Studies Transport Systems and Logistics
    Identifiers
    urn:nbn:se:liu:diva-115799 (URN)
    Available from: 2015-03-20 Created: 2015-03-20 Last updated: 2015-03-20Bibliographically approved
1 - 9 of 9
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