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Tending to innovate in Swedish primary health care: a qualitative study
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).ORCID iD: 0000-0001-6784-0133
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).ORCID iD: 0000-0001-8952-8773
Department of Social Work, University of Gothenburg, Göteborg, Sweden.
2019 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, article id 42Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Policymakers in many countries are involved in system reforms that aim to strengthen the primary care sector. Sweden is no exception. Evidence suggests that targeted financial micro-incentives can stimulate change in certain areas of care, but they do not result in more radical change, such as innovation. The study was performed in relation to the introduction of a national health care reform, and conducted in Jönköping County Council, as the region's handling of health care reforms has attracted significant national and international interest. This study employed success case method to explore what enables primary care innovations.

METHODS: Five Primary Health Care Centres (PHCCs) were purposively selected to ensure inclusion of a variety of aspects, such as size, location, ownership and regional success criteria. 48 in-depth interviews with managers and staff at the recruited PHCCs were analysed using content analyses. The COREQ checklist for qualitative studies was used to assure quality standards.

RESULTS: This study identified three types of innovations, which break with previous ways of organizing work at these PHCCs: (1) service innovation; (2) process innovation; and (3) organizational innovation. A learning-oriented culture and climate, comprising entrepreneurial leadership, cross-boundary collaboration, visible and understandable performance measurements and ability to adapt to external pressure were shown to be advantageous for innovativeness.

CONCLUSIONS: This qualitative study highlights critical features in practice that support primary care innovation. Managers need to consistently transform and integrate a policy "push" with professionals' understanding and values to better support primary care innovation. Ultimately, the key to innovation is the professionals' engagement in the work, that is, their willingness, capability and opportunity to innovate.

Place, publisher, year, edition, pages
BioMed Central, 2019. Vol. 19, no 1, article id 42
Keywords [en]
Culture and climate for innovation, Health care reform, Innovation, Leadership, Practice features, Primary care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-42700DOI: 10.1186/s12913-019-3874-yISI: 000456156900007PubMedID: 30658638Scopus ID: 2-s2.0-85060149714Local ID: GOA HHJ 2019OAI: oai:DiVA.org:hj-42700DiVA, id: diva2:1281435
Available from: 2019-01-22 Created: 2019-01-22 Last updated: 2019-02-20Bibliographically approved

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Avby, GunillaKjellström, Sofia

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Health Care Service and Management, Health Policy and Services and Health Economy

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