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  • 1.
    Acheampong, Faustina
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Vimarlund, Vivian
    Jönköping University, Jönköping International Business School, JIBS, Informatics. Jönköping University, Jönköping International Business School, JIBS, Centre for Information Technology and Information Systems (CenITIS). Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Innovating healthcare through remote monitoring: Effects and business model2017In: Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications, IGI Global, 2017, p. 247-268Chapter in book (Other academic)
    Abstract [en]

    Information technology has been suggested to improve patient health outcomes and reduce healthcare cost. This study explored the business model and effects of collaborative innovation between caregivers and patients on healthcare delivery through remote patient monitoring by interviewing caregivers and surveying atrial fibrillation patients. Findings indicate that remote monitoring enhanced early detection of potential risks and quality of clinical decision-making with patients feeling more empowered and involved in their own care. The remote monitoring system which consisted of a home-based ECG and a web-based service and was offered free to patients, brought together caregivers, patients, service provider and the government as actors. The introduction of remote monitoring increased the workload of caregivers and facilitation of timely diagnostics and decision-making were not realized. IT is an enabler of innovation in healthcare, but it must be integrated into work processes with a viable business model to realize potential benefits and sustain it. 

  • 2.
    Adams, Mary
    et al.
    King’s College London, UK.
    Maben, Jill
    King’s College London, UK.
    Robert, Glenn
    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). King’s College London, UK.
    ‘It’s sometimes hard to tell what patients are playing at’: How healthcare professionals make sense of why patients and families complain about care2018In: Health, ISSN 1363-4593, E-ISSN 1461-7196, Vol. 22, no 6, p. 603-623Article in journal (Refereed)
    Abstract [en]

    This article draws from sociological and socio-legal studies of dispute between patients and doctors to examine how healthcare professionals made sense of patients’ complaints about healthcare. We analyse 41 discursive interviews with professional healthcare staff working in eight different English National Health Service settings to explore how they made sense of events of complaint and of patients’ (including families’) motives for complaining. We find that for our interviewees, events of patients’ complaining about care were perceived as a breach in fundamental relationships involving patients’ trust or patients’ recognition of their work efforts. We find that interviewees rationalised patients’ motives for complaining in ways that marginalised the content of their concerns. Complaints were most often discussed as coming from patients who were inexpert, distressed or advantage-seeking; accordingly, care professionals hearing their concerns about care positioned themselves as informed decision-makers, empathic listeners or service gate-keepers. We find differences in our interviewees’ rationalisation of patients’ complaining about care to be related to local service contingences rather than to fixed professional differences. We note that it was rare for interviewees to describe complaints raised by patients as grounds for improving the quality of care. Our findings indicate that recent health policy directives promoting a view of complaints as learning opportunities from critical patient/consumers must account for sociological factors that inform both how the agency of patients is envisaged and how professionalism exercised contemporary healthcare work.

  • 3.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science.
    Integrating improvement learning into health professional educational curricula2008In: International Forum on Quality Improvement in Healthcare, France, April 24 2008: International Forum on QI , 2008, p. 1-Conference paper (Refereed)
    Abstract [en]

    We all need to start where we are and also wanting to go further all the time. This is the essence in quality improvement. The leader and the teachers must own this attitude themselves in order to have the ability to be trustworthy for the students. There is evidence in the literature about the impact of education on the professional attitude and role. This means that it is important to work with better professional development for better outcomes in the faculty.

    One starting point for us in the planning of our different programs are that improvement knowledge will be a streak through the whole education in order to establish a professional attitude of daily inspiration to produce the best practise. We have applied all curricula to Boologna declaration and in this system progression in learning is a key point. We have four levels in the basic education (3-years education which lead to Bachelor degree) where we start to introduce 1) Concepts and models in health improvement. Then let our students make a 2) Personal improvement in their everyday life. Later in the education we teach about 3) Evidence practise and systematic literature reviews. Finally the students are 4) Making health improvements in collaboration with the staff during one clinical education.

    All educational programmes on basic level since 2007 include aim descriptions about quality improvement. The aim of the learning is to have the competence to initiate and participate in work about health care improvements.

    Finally, besides the mentions aspects in improvement education there are some other factors that needs for better system performance.

  • 4.
    Aidemark, Jan
    et al.
    Linnaeus University.
    Askenäs, Linda
    Linnaeus University.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Strömberg, Anna
    Linköping University.
    User involvement in the co-design of self-care support systems for heart failure patients2015In: Procedia Computer Science, E-ISSN 1877-0509, Vol. 64, p. 118-124Article in journal (Refereed)
    Abstract [en]

    In this paper the nature of user involvement in a co-design process will be explored. The outlines of a research project aiming at developing support systems for self-care inpatients suffering from chronic heart failure will be presented. The project is planned to perform a co-design effort where users (patients and healthcare professionals) will be given the opportunity to influence the development of support systems. We will discuss a number of possibilities and challenges that lie in the design of this kind of project and also some findings from its early stages. This report presents the experiences of users’ input, which are discussed in the context of previous research on benefits of user contributions in systems development.

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  • 5.
    Alexanderson, Kristina
    et al.
    Karolinska Institutet, Försäkringsmedicin.
    von Knorring, Mia
    Karolinska Institutet, Försäkringsmedicin.
    Keller, Christina
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Impact of a nationwide government program in Sweden on how healthcare managers, in their organisations, manage the work with sickness certification of patients2014In: The European journal of public health, Vol. 24, Supplement 2, 2014, p. 90-Conference paper (Refereed)
  • 6.
    Algurén, Beatrix
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. University of Gothenburg, Faculty of Education, Department of Food and Nutrition, and Sport Science, Sweden.
    Andersson Gäre, Boel
    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). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Region Jönköping County, Futurum, Sweden.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson, Ann-Christine
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Quality indicators and their regular use in clinical practice – results from a survey among users of two cardiovascular National Registries in Sweden2018In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 30, no 10, p. 786-792Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the regular use of quality indicators from Swedish cardiovascular National Quality Registries (NQRs) by clinical staff; particularly differences in use between the two NQRs and between nurses and physicians.

    Design: Cross-sectional online survey study.

    Setting: Two Swedish cardiovascular NQRs: a) Swedish Heart Failure Registry and b) Swedeheart.

    Participants: Clinicians (n=185; 70% nurses, 26% physicians) via the NQRs’ email networks.

    Main outcome measures: Frequency of NQR use for a) producing healthcare activity statistics; b) comparing results between similar departments; c) sharing results with colleagues; d) identifying areas for quality improvement (QI); e) surveilling the impact of QI efforts; f) monitoring effects of implementation of new treatment methods; g) doing research; h) educating and informing healthcare professionals and patients.

    Results: Median use of NQRs was ten times a year (25th and 75th percentiles range: 3 – 23 times/year). Quality indicators from the NQRs were used mainly for producing healthcare activity statistics. Median use of Swedeheart was six times greater than SwedeHF (p<0.000). Physicians used the NQRs more than twice as often as nurses (18 vs. 7.5 times/year; p<0.000) and perceived NQR work more often as meaningful. Around twice as many Swedeheart users had the role to participate in data analysis and in QI efforts compared to SwedeHF users.

    Conclusions: Most respondents used quality indicators from the two cardiovascular NQRs infrequently (< 3 times/year). The results indicate that linking registration of quality indicators to using them for QI activities increases their routine use and makes them meaningful tools for professionals.

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  • 7.
    Algurén, Beatrix
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Coenen, Michaela
    Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Research Unit for Biopsychosocial Health, LMU Munich, Munich, Germany.
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Fridlund, Bengt
    Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.
    A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales2020In: Journal of Patient-Reported Outcomes, ISSN 2509-8020, Vol. 4, no 1, article id 7Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health.

    METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO's International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules.

    RESULTS: A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients' daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease.

    CONCLUSIONS: Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.

  • 8.
    Algurén, Beatrix
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Faculty of Education, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Jernberg, Tomas
    Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institute, Stockholm, Sweden.
    Vasko, Peter
    Department of Internal Medicine, Central Hospital, Växjö, Sweden.
    Selb, Melissa
    ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications (at DIMDI), Nottwil, Switzerland; and Swiss Paraplegic Research, Nottwil, Switzerland .
    Coenen, Michaela
    ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications (at DIMDI), Nottwil, Switzerland; Department of Medical Information Processing, Biometry and Epidemiology-IBE, Chair of Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany; and Pettenkofer School of Public Health (PSPH), Munich, Germany .
    Content comparison and person-centeredness of standards for quality improvement in cardiovascular health care2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 1, article id e0244874Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Quality standards are important for improving health care by providing compelling evidence for best practice. High quality person-centered health care requires information on patients' experience of disease and of functioning in daily life.

    OBJECTIVE: To analyze and compare the content of five Swedish National Quality Registries (NQRs) and two standard sets of the International Consortium of Health Outcomes Measurement (ICHOM) related to cardiovascular diseases.

    MATERIALS AND METHODS: An analysis of 2588 variables (= data items) of five NQRs-the Swedish Registry of Congenital Heart Disease, Swedish Cardiac Arrest Registry, Swedish Catheter Ablation Registry, Swedish Heart Failure Registry, SWEDEHEART (including four sub-registries) and two ICHOM standard sets-the Heart Failure Standard Set and the Coronary Artery Disease Standard Set. According to the name and definition of each variable, the variables were mapped to Donabedian's quality criteria, whereby identifying whether they capture health care processes or structures or patients' health outcomes. Health outcomes were further analyzed whether they were clinician- or patient-reported and whether they capture patients' physiological functions, anatomical structures or activities and participation.

    RESULTS: In total, 606 variables addressed process quality criteria (31%), 58 structure quality criteria (3%) and 760 outcome quality criteria (38%). Of the outcomes reported, 85% were reported by clinicians and 15% by patients. Outcome variables addressed mainly 'Body functions' (n = 392, 55%) or diseases (n = 209, 29%). Two percent of all documented data captured patients' lived experience of disease and their daily activities and participation (n = 51, 3% of all variables).

    CONCLUSIONS: Quality standards in the cardiovascular field focus predominately on processes (e.g. treatment) and on body functions-related outcomes. Less attention is given to patients' lived experience of disease and their daily activities and participation. The results can serve as a starting-point for harmonizing data and developing a common person-centered quality indicator set.

  • 9.
    Algurén, Beatrix
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Food and Nutrition and Sport Science, University of Gothenburg, Faculty of Education, Gothenburg, Sweden.
    Nordin, Annika
    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).
    Andersson-Gäre, Boel
    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). Futurum, Region Jönköping County, Jönköping, Sweden.
    Peterson, Anette
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköping County, Jönköping, Sweden.
    In-depth comparison of two quality improvement collaboratives from different healthcare areas based on registry data - Possible factors contributing to sustained improvement in outcomes beyond the project time2019In: Implementation Science, E-ISSN 1748-5908, Vol. 14, no 1, article id 74Article in journal (Refereed)
    Abstract [en]

    Background: Quality improvement collaboratives (QICs) are widely used to improve healthcare, but there are few studies of long-term sustained improved outcomes, and inconsistent evidence about what factors contribute to success. The aim of the study was to open the black box of QICs and compare characteristics and activities in detail of two differing QICs in relation to their changed outcomes from baseline and the following 3 years.

    Methods: Final reports of two QICs - one on heart failure care with five teams, and one on osteoarthritis care with seven teams, including detailed descriptions of improvement projects from each QIC's team, were analysed and coded by 18 QIC characteristics and four team characteristics. Goal variables from each team routinely collected within the Swedish Heart Failure Registry (SwedeHF) and the Better Management of Patients with OsteoArthritis Registry (BOA) at year 2013 (baseline), 2014, 2015 and 2016 were analysed with univariate statistics.

    Results: The two QICs differed greatly in design. The SwedeHF-QIC involved eight experts and ran for 12 months, whereas the BOA-QIC engaged three experts and ran for 6 months. There were about twice as many activities in the SwedeHF-QIC as in the BOA-QIC and they ranged from standardisation of team coordination to better information and structured follow-ups. The outcome results were heterogeneous within teams and across teams and QICs. Both QICs were highly appreciated by the participants and contributed to their learning, e.g. of improvement methods; however, several teams had already reached goal values when the QICs were launched in 2013.

    Conclusions: Even though many QI activities were carried out, it was difficult to see sustained improvements on outcomes. Outcomes as specific measurable aspects of care in need of improvement should be chosen carefully. Activities focusing on adherence to standard care programmes and on increased follow-up of patients seemed to lead to more long-lasting improvements. Although earlier studies showed that data follow-up and measurement skills as well as well-functioning data warehouses contribute to sustained improvements, the present registries' functionality and QICs at this time did not support those aspects sufficiently. Further studies on QICs and their impact on improvement beyond the project time should investigate the effect of those elements in particular. 

  • 10.
    An, Jing
    Jönköping University, School of Education and Communication.
    Participation in Outside Home Activities in China: A comparison of Typically Developing Children and Children with Developmental Disabilities2021Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are personal factors and environmental factors playing impacts on the participation of children with developmental disabilities in China. Aim: The aim of this study is to investigate the participation of children with developmental disabilities in outside home activities compared to typically developing children. Method: A quantitative cross-sectional method was used in this study. Participants were children with developmental disabilities (autism spectrum disorder and intellectual disabilities) and typically developing children between the age of 5 to 13. An instrument called ‘Picture My Participation’ (Simplified Chinese version) was used for data collection. Results: In general, typically developing children attended more frequently and felt more involved than children with developmental disabilities in outside home activities. There were many similarities in attendance between the two groups of children. They both attended more frequently in formal learning at school, shopping and playing with others, and less frequently in spiritual activities, social activities, and trips. Some differences were found in the activities with lower levels of involvement. Apart from the spiritual activity with the lowest mean score of involvement in both groups, typically developing children felt less involved in organized leisure and trips. However, children with developmental disabilities had lower levels of involvement in health center visits and social activities. There was no significant association between age, gender, place of residence, and participation in neither the attendance nor involvement aspect. Conclusion: Both intrinsic and extrinsic factors play essential parts in the participation of children with developmental disabilities. More support should be provided to children with DD.

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  • 11.
    Anderson, Janet E.
    et al.
    Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK.
    Robert, Glenn
    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). Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK.
    Nunes, Francisco
    Department of Human Resources and Organizational Behavior, ISCTE-IUL, Lisbon, Portugal.
    Bal, Roland
    Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Netherlands.
    Burnett, Susan
    Faculty of Medicine, Department of Surgery & Cancer, Imperial College, UK.
    Karltun, Anette
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Sanne, Johan
    IVL Swedish Environmental Research Institute, Sweden.
    Aase, Karina
    SHARE—Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Norway.
    Wiig, Siri
    SHARE—Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Norway.
    Fulop, Naomi J.
    Department of Applied Health Research, University College London, UK.
    The QUASER Team, ,
    Translating research on quality improvement in five European countries into a reflective guide for hospital leaders: the ‘QUASER Hospital Guide’2019In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 31, no 8, p. G87-G96Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to translate the findings of the QUASER study into a reflective, dialogic guide to help senior hospital leaders develop an organization wide QI strategy.

    Design: The QUASER study involved in depth ethnographic research into QI work and practices in two hospitals in each of five European countries. Three translational stakeholder workshops were held to review research findings and advise on the design of the Guide. An extended iterative process involving researchers from each participant country was then used to populate the Guide.

    Setting: The research was carried out in two hospitals in each of five European countries.

    Participants: In total, 389 interviews with healthcare practitioners and 803 hours of observations.

    Intervention: None.

    Main outcome measure: None.

    Results: The QUASER Hospital Guide was designed for leadership teams to diagnose their organization’s strengths and weaknesses in the eight QI challenges. The Guide supports organizational dialogue about QI challenges, enables leaders to share perspectives, and helps teams to develop solutions to their situated problems. The Guide includes extensive examples of QI strategies drawn from the data and is published online and on paper.

    Conclusion: The QUASER Hospital Guide is empirically based, draws on a dialogical approach to Organizational Development and complexity science and can facilitate hospital leadership teams to identify the best solutions for their organization.

  • 12.
    Andersson, Ann-Christine
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    How to reach effective health service delivery?2017In: Journal of General Practice, ISSN 2329-9126, Vol. 5, no 4, article id 1000320Article in journal (Refereed)
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  • 13.
    Andersson, Ann-Christine
    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).
    Kvalitetsarbete inom omvårdnad – förbättringskunskap och ständiga förbättringar2018In: Kvalitetsutveckling inom omvårdnad: sjuksköterskans professionella ansvar / [ed] A. Hommel & Å. Andersson, Lund: Studentlitteratur AB, 2018, p. 45-68Chapter in book (Other academic)
  • 14.
    Andersson, Ann-Christine
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Ainalem, Ingrid
    Centre for Innovation and Improvement (CII), Region Skåne, Malmö, Sweden.
    Berg, Agneta
    School of Health and Society, Kristianstad University, Sweden.
    Janlov, Ann-Christin
    School of Health and Society, Kristianstad University, Sweden.
    Challenges to improve inter-professional care and service collaboration for people living with psychiatric disabilities in ordinary housing2016In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 25, no 1, p. 44-52Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking backevaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

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  • 15.
    Andersson, Ann-Christine
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson Gäre, Boel
    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). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Thor, Johan
    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).
    Lenrick, Raymond
    Rapport om utvärdering av IVO:s lärande tillsyn2018Report (Other academic)
    Abstract [sv]

    Inspektionen för vård och omsorg (IVO) har i sin tillsynspolicy lagt fokus på att främja lärande för att stödja utvecklingen av god kvalitet och säkerhet i vård och omsorg. Under 2017 har IVO givit Jönköping Academy for Improvement of Health and Welfare vid Jönköping University i uppdrag att utvärdera tillämpning av lärande tillsyn. Syftet med denna studie var att belysa om, och om möjligt hur, IVO:s tillsyn kan stödja verksamhetsutveckling och förbättring i de tillsynade verksamheter. Det finns många teoribildningar kring lärande och kvalitetsutveckling. Denna rapport tar utgångspunkt i teorier om organisatoriskt lärande, samskapande och förbättringskunskap och belyser vad som kan bidra, och i så fall hur, till en ömsesidig tillit som leder till ett fördjupat lärande som grund för förbättring.

    Studien omfattar två tillsyner, där deltagarna bestod av personal från de berörda verksamheterna, samt IVO-inspektörer från de regionala IVO avdelningar. Det empiriska materialet samlades in genom intervjuer och en observation. En dokumentgenomgång av relevanta IVO dokument skapade underlag för utvecklandet av studiens intervjuguider. Intervjuerna bandades, transkriberades och analyserades med en metod inspirerad av tematisk analys, som utmynnade i fem teman: (I) Förberedelse inför tillsyn; (II) Genomförande i verksamheten; (III) Resultat i verksamheten; (IV) Förutsättningar för lärande; och (V) Önskemål för ökat lärande. Samtliga teman innehåller både förhållanden som stödjer (främjar) och som försvårar (hindrar) lärande:

    • Förberedelsearbetet ansågs inte bidra till en ökad tillit som förutsättning för lärande. Det uttrycktes en önskan om mer samskapande i förberedelsearbetet redan innan tillsynstillfället
    • Det framkom önskemål om att lärandet, som ett av målen med tillsynen, skulle lyftas tydligare i dialogen vid tillsynstillfället.
    • Det uppfattades som svårt att peka på reella resultat i verksamheterna som direkt berodde på tillsynen, men det beskrevs ändå som viktigt att tillsynen fanns.
    • Det fanns olika uppfattningar om hur IVO:s roll som tillsynsmyndighet påverkade lärandet. Ett större fokus på gemensam uppföljning skulle vara ett sätt att optimera lärandet både i verksamheterna och hos IVO:s inspektörer.
    • Ett lärande skulle gynnas av en tydlig gemensam problembeskrivning, samt fortlöpande uppföljningar och delad kunskap, exempelvis genom goda exempel och dialogkonferenser.

    Generellt fanns en stor samstämmighet mellan IVO:s inspektörer och de verksamhetsföreträdare som intervjuats, men vissa skillnader framkom också. Rapporten avslutas med några avslutande reflektioner.

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  • 16.
    Andersson, Ann-Christine
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson-Gäre, Boel
    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).
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Melke, Anna
    Erfarenheter från lärandeseminarier: Barn som anhöriga: Reflektioner från följeforskning2016Report (Other academic)
    Abstract [sv]

    Under 2015 genomfördes nationella lärandeseminarier för att stärka implementeringen av den lag som ger barn rätt till information, råd och stöd när en förälder plötsligt avlider, är svårt sjuk eller skadad (HSL 2g §). Satsningen var ett förbättringsarbete som omfattade sex landsting som med hjälp av en projektledning träffades vid fyra tillfällen från januari till september. Två av träffarna skedde i Stockholm och två var digitala. Under våren 2015 knöts följeforskning till arbetet med frågeställningar om vilka resultat förbättringsarbetet gav och hur deltagarna upplevde arbetssättet. Syftet var att lyfta fram vad satsningen gav samt att lära inför framtida satsningar – är lärandeseminarier ett användbart arbetssätt för nationella implementeringssatsningar?

    Rapporten visar att lärandeseminarier tycks vara en användbar form. Teamen kan redovisa att de uppnått många av de mål som de föresatte sig under projekttiden. Det handlade om kartläggning av kunskapsläge och strukturer, kompetensutveckling samt utveckling av rutiner och material. Teamen uppskattade också att få delta i ett nationellt sammanhang som gav inspiration. Samtidigt framkom det önskemål om fortsatt och ännu mer handfast stöd i fortsatt implementering i klinisk verksamhet.

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  • 17.
    Andersson, Ann-Christine
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Andersson-Gäre, Boel
    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). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Melke, Anna
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. The Göteborg Region Association of Local Authorities, Gothenburg, Sweden.
    Learning through networking in healthcare and welfare: The use of a breakthrough collaborative in the Swedish context2020In: International Journal of Healthcare Management, ISSN 2047-9700, E-ISSN 2047-9719, Vol. 13, no 3, p. 236-244Article in journal (Refereed)
    Abstract [en]

    Breakthrough Collaborative (BC) aims at learning through networking, mainly at micro level, and is used as a tool to improve care and welfare organizations. The aim of this study was to explore and illuminate the challenges when applying BC model at meso and macro level. In 2010, the Swedish Health and Medical Services Act stated the responsibility of healthcare professionals to consider children’s needs as relatives. This study uses an interactive collaborative research model. To support healthcare organizations in the implementation of the regulation, county councils/regions in Sweden were invited to take part in a BC during 2015. Six teams from different county councils/regions participated. Team members were interviewed several times during the project time. Data were analyzed with an explorative and descriptive qualitative content analysis. The result illuminates the challenges faced when applying BC at meso and macro level. Most challenges concern preparation, support structures and system connections. There are similarities with the challenges met at micro level when BC is used at meso and macro level. But it seems even more important to consider how the team is constituted at meso and macro level to make use of the learnings and achieve long-term impact in the home organization.

  • 18.
    Andersson, Ann-Christine
    et al.
    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). Futurum-Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Melke, Anna
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Göteborg Region Association of Local Authorities, Gothenburg, Sweden.
    Andersson Gäre, Boel
    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). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Futurum-Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Identification of children as relatives with a systematic approach: a prerequisite in order to offer advice and support2018In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 27, no 3, p. 172-177Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to elucidate conditions at all system levels in a specific health care service to develop practices for identification of children as relatives. An interactive research approach with the intention to create mutual learning between practice and research was used. The participating health care service cared for both clinic in- and outpatients with psychiatric disorders. Health care professionals from different system levels (micro, meso, macro) participated, representing different professions. At the first project meeting, it was obvious that there was no systematic approach to identify children as relatives. At the micro level, activities such as a pilot survey and an open house activity were carried out. At the meso level, it was discussed how to better support collaboration between units. At the management (macro) level, it was decided that all units should appoint at least one child agent, with the aim to increase collaboration throughout the whole health care service. To change focus, in this case from only parents to inclusion of children, is an important challenge faced by health care services when forced to incorporate new policies and regulations. The new regulations contribute to increased complexity in already complex organizations. This study highlights that such challenges are underestimated.

  • 19.
    Andersson Bäck, Monica
    et al.
    University of Gothenburg.
    Kjellström, Sofia
    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). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Avby, Gunilla
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Identity work of successful primary care managers and competing institutional logics2017Conference paper (Refereed)
  • 20.
    Andersson Bäck, Monica
    et al.
    University of Gothenburg.
    Kjellström, Sofia
    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). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Avby, Gunilla
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Medical manager hybrids for handling institutional complexity and change in primary care2017Conference paper (Refereed)
    Abstract [en]

    Introduction: This article deals with hybrid persons combining medical professionalism and management for handling institutional complexity and change in primary care. Primary care and identity are in transition in many western countries, in Sweden emphasized by the 2007 reform for patient choice and competition. Research has shown that embedded hybrid actors, familiar and socialized in a field and to its logics, tend to be influential for handling complexity and change. Yet hydrids and their enactment in primary care is an underexplored area.

    Aim: The aim is to contribute to our understanding of hybrid persons and how they are combining medical professionalism and management in primary care, while managing complexity and change.

    Material and methods: In a case study of six successful primary healthcare centers, public and private, covering 56 interviews and observations with various professions, two medical managers ‘hybrids’ showed to be particularly interesting. These were analyzed in-depth, including analysis of staff’s and colleagues’ experiences and contrasted by other managers and hybrids. For the analysis we draw on institutional logic perspective (Thornton, Occasion & Lounsbury 2012) in order to capture preconditions as well as enactment of such change agents.

    Results/conclusions: The hydrids contributed to innovation, creativity and learning in their primary care centres. At their workplace, coherence and a good ambience coexisted with feelings of high work pace and lacking role clarity among the multidisciplinary staff. Categorized in line with McGivern and colleagues(2015) term as ‘willing hybrids’, the persons studied revealed high ambitions to challenge existing institutional order giving professionalism new forms, while seeking to innovate practices and division of work among healthcare staff in primary care. By doing so the hybrids integrated professionalism and managerialism and were influential in reframing problems and solutions, which aligned several logics at play. However several obstacles related to professional as well as bureaucratic issues appeared along the way.

  • 21. Andersson, Christina
    et al.
    Johansson, Niklas
    Verksamhetsadministration: En studie om hur chefer i Region Jönköpings län upplever sitt behov av administrativt stöd2021Independent thesis Basic level (professional degree), 20 HE creditsStudent thesis
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  • 22.
    Andersson, Karolina
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Införande av egenmonitorering ur ett komplexitetsperspektiv: Ett förbättringsarbete för trygg och säker vård hemma för patienter med hjärtsvikt2021Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [en]

    Patients with chronic heart failure account for half of all internal medicine diagnoses at Södertälje Hospital. As one of the symptoms is shortness of breath, patients often seek care in an acute stage with worry and anxiety. By enabling patients to get to know, and be involved, in their wellbeing, relapses with symptoms such as shortness of breath may be prevented and reduce the need to seek emergency care. To accomplish this, digital technology is used to enable patients to take and monitor their own health measurements and put these in relation to their wellbeing and lifestyle. To further strengthen the patient's self-care, the clinic is monitoring the patient's vital functions through a communicationsplatform. The purpose of the improvement work is to reduce patients with heart failure’s need of hospital care and instead allow them to stay at home with self-monitoring and receive care at home. The goal is that before 2021-03-31, 10 patients in need of hospital care at Södertälje Hospital heart failure will participate in a pilot test with self-monitoring and report safety and increased sense of safety with selfmonitoring.This study aims to clarify which conditions that affect the transition from traditional inpatient care to self-monitoring for people with heart failure. The improvement work resulted in eight patients being included. The study shown that before an organization introduces self-monitoring, the complexity of healthcare should be considered. Good infrastructures for IT are crucial and the technology needs to be more flexible so that patients who do not have Swedish as a language can take part in self-monitoring.

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  • 23.
    Andersson, Lars Fredrik
    et al.
    Dept. of Economic History and Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden.
    Eriksson, Liselotte
    Umeå Centre for Gender Studies and Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden.
    Nystedt, Paul
    Jönköping University, Jönköping International Business School, JIBS, Economics. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Workplace accidents and workers’ solidarity: mutual health insurance in early twentieth-century Sweden2022In: Economic history review, ISSN 0013-0117, E-ISSN 1468-0289, Vol. 75, no 1, p. 203-234Article in journal (Refereed)
    Abstract [en]

    During the industrialization period, the rate of workplace-related accidents increased. Because of the lack of public insurance, mutual health insurance societies became the main providers of workplace accident insurance among workers. Due to large differences in accident risk, health insurance societies were potentially exposed to the risk of adverse selection, since they employed equal pricing for all members regardless of risk profile. This article investigates the impact of workplace accident risk on health insurance selection and outcomes. We employ household budget surveys encompassing urban workers in Sweden during the early twentieth century. We find evidence for a redistribution from low- to high-risk-exposed workers, as workplace accident risk had a significant and positive impact on receiving health insurance benefits, also when controlling for a variety of factors. Workers exposed to greater risks in the workplace were more likely to have health insurance but did not pay higher premiums. The redistribution from low- to high-risk-exposed workers was largely accepted and viewed as an act of solidarity between workers. Given that health insurance societies were aware of this redistribution, we argue for the presence of informed, rather than adverse, selection.

  • 24.
    Andersson Pitkänen, Linn
    et al.
    Jönköping University.
    Quist, Maja
    Jönköping University.
    Relationskontinuitet i hälso- och sjukvårdens patientflöden: En fallstudie i svensk primärvård ur ett flödesperspektiv2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Purpose - The quality of health care is lacking, and increased continuity of care can contribute to and be a prerequisite for increasing quality. Despite the knowledge of the good effects of continuity of care, there is a knowledge gap in what it takes to achieve it. Thus, the purpose of the study is:

    To investigate barriers and opportunities for continuity of care in healthcare patient flows.

    Method - The study is a case study that combines both qualitative and quantitative data. The study began with a pilot study that included literature studies and dialogues with the organization. To collect data, the data collection techniques used were document study, observation and interview. The collected data were analyzed continuously and was compared and strengthened by theory to confirm the validity of the study. To further increase validity, triangulation was considered as an essential part of the study.

    Results - The study's results show that the extent of continuity of care is seen to differ between ambition and ability, the ambition is high, but the ability is low. Furthermore, the barriers to continuity of care were identified as a lack of availability in terms of staff, the healthcare IT system and the idea of the current way of working as a single solution to maintain continuity of care. Additional barriers identified were emergency cases and the time aspect. Based on the barriers, improvement proposals have been developed, through changes that should take place in the long term, but also how the work for continuity of care can be improved through the existing conditions.

    Implications - Based on the results of the study, theoretical and practical implications have been developed. A new dimension of existing theory has been discovered, which suggests that flow efficiency can lead to continuity of care. Through this, it has also been established that the flow perspective can have good effects in health care. It has been confirmed that there is a lack of continuity of care, and a deeper understanding of the reasons for this has been obtained. Practical implications have been obtained in the form of the improvement proposals produced in the results.

    Limitations - The case study is designed as a single case design, which limits the generalizability of the study as only one unit of analysis has been studied. It has been observed during the study that there are misregistration’s in the healthcare IT system. Document study data have been drawn from this system, resulting in a limitation of the reliability of that data.

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  • 25.
    Andersson, T.
    et al.
    School of Business, University of Skövde, Skövde, Sweden.
    Linnéusson, Gary
    Jönköping University, School of Engineering, JTH, Industrial Product Development, Production and Design.
    Holmén, M.
    Innovation Platform, Region Västra Götaland, Gothenburg, Sweden.
    Kjellsdotter, A.
    Research and Development Centre, Skaraborg Hospital, Skövde, Sweden.
    Nurturing innovative culture in a healthcare organisation: Lessons from a Swedish case study2022In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 37, no 9, p. 17-33Article in journal (Refereed)
    Abstract [en]

    Purpose: Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation. Design/methodology/approach: Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps. Findings: The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important. Practical implications: This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process. Originality/value: The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.

  • 26.
    Andersson, Thomas
    et al.
    Univ Skovde, Sch Business, Skovde, Sweden.;VID Specialized Univ, Fac Theol Diaconia & Leadership Studies, Oslo, Norway..
    Eriksson, Nomie
    Univ Skovde, Sch Business, Skovde, Sweden..
    Müllern, Tomas
    Jönköping University, Jönköping International Business School, JIBS, Business Administration. Jönköping University, Jönköping International Business School, JIBS, Media, Management and Transformation Centre (MMTC).
    Clinicians' psychological empowerment to engage in management as part of their daily work2023In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 36, no 9, p. 272-287Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of the article is to analyze how physicians and nurses, as the two major health care professions, experience psychological empowerment for managerial work.

    Design/methodology/approach: The study was designed as a qualitative interview study at four primary care centers (PCCs) in Sweden. In total, 47 interviews were conducted, mainly with physicians and nurses. The first inductive analysis led us to the concept of psychological empowerment, which was used in the next deductive step of the analysis.

    Findings: The study showed that both professions experienced self-determination for managerial work, but that nurses were more dependent on structural empowerment. Nurses experienced that they had competence for managerial work, whereas physicians were more ignorant of such competence. Nurses used managerial work to create impact on the conditions for their clinical work, whereas physicians experienced impact independently. Both nurses and physicians experienced managerial work as meaningful, but less meaningful than nurses and physicians' clinical work.

    Practical implications: For an effective health care system, structural changes in terms of positions, roles, and responsibilities can be an important route for especially nurses' psychological empowerment.

    Originality/value: The qualitative method provided a complementary understanding of psychological empowerment on how psychological empowerment interacted with other factors. One such aspect was nurses' higher dependence on structural empowerment, but the most important aspect was that both physicians and nurses experienced that managerial work was less meaningful than clinical work. This implies that psychological empowerment for managerial work may only make a difference if psychological empowerment does not compete with physicians' and nurses' clinical work.

  • 27.
    Andersson, Thomas
    et al.
    School of Business, University of Skövde, Skövde, Sweden.
    Eriksson, Nomie
    School of Business, University of Skövde, Skövde, Sweden.
    Müllern, Tomas
    Jönköping University, Jönköping International Business School, JIBS, Accounting, Marketing, SCM, Informatics and Law.
    Patients' perceptions of quality in Swedish primary care - a study of differences between private and public ownership2021In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 35, no 9, p. 85-100Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of the paper is to describe and analyze differences in patients' quality perceptions of private and public primary care centers in Sweden.

    DESIGN/METHODOLOGY/APPROACH: The article explores the differences in quality perceptions between patients of public and private primary care centers based on data from a large patient survey in Sweden. The survey covers seven dimensions, and in this paper the measure Overall impression was used for the comparison. With more than 80,000 valid responses, the survey covers all primary care centers in Sweden which allowed for a detailed analysis of differences in quality perceptions among patients from the different categories of owners.

    FINDINGS: The article contributes with a detailed description of different types of private owners: not-for-profit and for profit, as well as corporate groups and independent care centers. The results show a higher quality perception for independent centers compared to both public and corporate groups.

    RESEARCH LIMITATIONS/IMPLICATIONS: The small number of not-for-profit centers (21 out of 1,117 centers) does not allow for clear conclusions for this group. The results, however, indicate an even higher patient quality perception for not-for-profit centers. The study focus on describing differences in quality perceptions between the owner categories. Future research can contribute with explanations to why independent care centers receive higher patient satisfaction.

    SOCIAL IMPLICATIONS: The results from the study have policy implications both in a Swedish as well as international perspective. The differentiation between different types of private owners made in this paper opens up for interesting discussions on privatization of healthcare and how it affects patient satisfaction.

    ORIGINALITY/VALUE: The main contribution of the paper is the detailed comparison of different categories of private owners and the public owners.

  • 28.
    Anell, Anders
    et al.
    Lund University School of Economics & Management, Lund, Sweden.
    Arvidsson, Eva
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköping County, Jönköping, Sweden.
    Dackehag, Margareta
    Lund University School of Economics & Management, Lund, Sweden.
    Ellegård, Lina Maria
    Lund University School of Economics & Management, Lund, Sweden.
    Glenngård, Anna Häger
    Lund University School of Economics & Management, Lund, Sweden.
    Access to automated comparative feedback reports in primary care: a study of intensity of use and relationship with clinical performance among Swedish primary care practices2024In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, no 1, article id 33Article in journal (Refereed)
    Abstract [en]

    Background: Digital applications that automatically extract information from electronic medical records and provide comparative visualizations of the data in the form of quality indicators to primary care practices may facilitate local quality improvement (QI). A necessary condition for such QI to work is that practices actively access the data. The purpose of this study was to explore the use of an application that visualizes quality indicators in Swedish primary care, developed by a profession-led QI initiative (“Primärvårdskvalitet”). We also describe the characteristics of practices that used the application more or less extensively, and the relationships between the intensity of use and changes in selected performance indicators. Methods: We studied longitudinal data on 122 primary care practices’ visits to pages (page views) in the application over a period up to 5 years. We compared high and low users, classified by the average number of monthly page views, with respect to practice and patient characteristics as well as baseline measurements of a subset of the performance indicators. We estimated linear associations between visits to pages with diabetes-related indicators and the change in measurements of selected diabetes indicators over 1.5 years. Results: Less than half of all practices accessed the data in a given month, although most practices accessed the data during at least one third of the observed months. High and low users were similar in terms of most studied characteristics. We found statistically significant positive associations between use of the diabetes indicators and changes in measurements of three diabetes indicators. Conclusions: Although most practices in this study indicated an interest in the automated feedback reports, the intensity of use can be described as varying and on average limited. The positive associations between the use and changes in performance suggest that policymakers should increase their support of practices’ QI efforts. Such support may include providing a formalized structure for peer group discussions of data, facilitating both understanding of the data and possible action points to improve performance, while maintaining a profession-led use of applications.

  • 29.
    Anna, Sennerö
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Fokus nutrition - när engagemang och kunskap förbättrar patienters hälsotillstånd: En fallstudie av ett förbättringsarbete av nutritionsprocessen på en medicinsk vårdavdelning på Capio S:t Görans Sjukhus.2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background Malnutrition is associated with decreased quality of life, depression, prolonged hospitalization and shortened lifetime. This master thesis describes the study of improvement through involving an improvement team working in two medical departments that treat patients with hematological, oncological and lung diseases.

    Purpose The purpose of the quality improvement is to support better health by improving the nutrition process. The purpose of the study is to describe how the improvement team through its work creates commitment int the department.

    Method Nolan’s model with PDSA-cycles and description of microsystem with 5P-model are used for the improvement. A case study that included semi-structured interviews was performed with content analysis. An employee questionnaire regarding nutrition knowledge was also performed which provided quantitative data.

    Results The result of the improvement shows a greater number of cost registrations but not jet higher daily intakes of energy. The result of the study describes how the improvement team has affected the improvement work based on the following themes: existence and dynamics, individualized guide and shared understanding of the goal.

    Conclusion The study of the improvement work shows that the improvement work has contributed to an increased level of knowledge in nutrition both in the improvement team and in the department. The study also shows that a dynamic improvement team can influence the culture of the department by increasing commitment

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  • 30.
    ARANITI, AIKATERINI
    Jönköping University, School of Education and Communication.
    Perceptions and Experiences of Social Participation in Physical Activties Among Youths with Physical Disabilities in Greece.: A qualitative Empirical Study2021Independent thesis Advanced level (degree of Master (Two Years)), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    How youths’ with physical disabilities experience social participation in physical activities is a subject that has not been extensively researched in Greece. Asking youths can give a deeper insight of their perceptions related to their social participation and how their contexts contribute to that. The family Participation Related Construct (fPRC) framework was used under the umbrella of the Systems Theory to guide the whole procedure of this study. A qualitative approach was conducted by five in-depth interviews with Greek youths (mean age 23) with physical disabilities using online video-call applications. A deductive content analysis was applied for this study, including four themes: 1) the construct of participation in the context of physical activity, 2) Intrinsic factors that influence social participation, 3) Intrinsic factors that are influenced by social participation, and 4) extrinsic factors that influence social participation. Results showed that youths overall described their social participation as a sense of belongingness and social connection with others. They perceived that attending the physical activities that were meaningful to them strongly influenced their social involvement. They also described that social participation in those specific contexts increased their self-confidence. Admittedly, family and activities were contextual aspects that positively influenced youths’ social participation. Results also showed the negative influence of the environment, such as the accessibility, state support and the COVID-19 pandemic, either directly or indirectly influenced youths’ social participation. Findings of this study support the need for future practical interventions in the Greek community, considering all aspects of the fPRC framework. Finally, collecting a broader number of perspectives will benefit the presented topic in order to create a more holistic view of what needs to be done to bring balance into the system. 

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  • 31.
    Areskoug Josefsson, Kristina
    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). Department for Behavioural Science, Oslo Metropolitan University, Oslo, Norway; VID Specialized University, Faculty of Health Studies, Sandnes, Norway.
    Moving societies towards better inclusion of sexual health in rehabilitation2021Conference paper (Refereed)
  • 32.
    Areskoug Josefsson, Kristina
    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). Department for Behavioural Science, Oslo Metropolitan University, Oslo, Norway; VID Specialized University, Faculty of Health Studies, Sandnes, Norway.
    Sexual health for all – It is important in rehabilitation!2021Conference paper (Refereed)
  • 33.
    Areskoug Josefsson, Kristina
    et al.
    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). Department for Behavioural Sciences, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
    Almborg, Ann-Helene
    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). Department of Register and Statistics, National Board of Health and Welfare, Stockholm, Sweden; Department of Classifications and Terminology in Healthcare, Norweigan Directorate of E-health, Nordic WHO-FIC CC, Oslo, Norway.
    Using ICF and ICHI to promote sexual health2021In: Cogent Medicine, E-ISSN 2331-205X, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    Sexual health is an important but often neglected field in health and welfare practice. Using structured documentation in a systematic work process can promote sexual health care including rehabilitation. Objectives: To present an overview of the usefulness of International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHI) concerning sexual health in the care process, in the electronic health record (EHR) and for follow-up of results. Using experience from practice and research to identify relevant information in health care processes related to sexual health, which are coded by using ICF and ICHI. The ICF and ICHI can be useful tools to describe functioning, patient's goals, results, planned and performed interventions for investigation, treatment, prevention, and follow-up at individual level in care processes concerning sexual health with unified and unambiguous terms, concepts, and codes in the EHR. Using the ICF and ICHI can support improvement of individual sexual health care including rehabilitation, and also support follow-up and quality management at local to global level within the domain of sexual health.

  • 34.
    Areskoug Josefsson, Kristina
    et al.
    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).
    Avby, Gunilla
    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).
    Andersson Bäck, Monica
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Kjellström, Sofia
    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).
    Workers’ experiences of healthy work environment indicators at well-functioning primary care units in Sweden: a qualitative study2018In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, no 4, p. 406-414Article in journal (Refereed)
    Abstract [en]

    Objective: Staff experiences of healthy work environment (HWE) indicators at primary care units can assist in understanding why some primary care units function better than others. The aim of the study was to create increased understanding of how workers experienced HWE indicators at well-functioning primary care units.

    Design: Fifty in-depth interviews with staff at six primary care units in Sweden were analysed with deductive content analysis, revisiting a systematic review of HWE indicators.

    Results: The study presents additional perspectives on staff experiences of HWE indicators at well-functioning primary care units. The included primary care units (PCU) shared a similar pattern of work environment indicators, with unique solutions and strategies to meet shared challenges. Staff at the included PCUs were encouraged to work to create and sustain a HWE, but each domain (indicator) also provided challenges that the staff and organisation needed to meet. The results suggest that useful approaches for a healthy work environment could be to address issues of organisational virtuousness, employee commitment and joy at work.

    Conclusions: Both managers and staff are encouraged to actively work not only to create and sustain an HWE but also to promote organisational virtuousness, employee commitment, joy at work and to increase the performance at work, which is of benefit to staff, patients and society.

    Key Points

    • Staff at well-functioning primary care units (PCUs) experienced healthy work environments
    • The included PCUs shared a similar pattern of work environment indicators, with unique solutions and strategies to meet shared challenges.
    • Staff at the included PCUs were encouraged to work to create and sustain a healthy work environment, but each domain (indicator) also provided challenges that the staff and organisation needed to meet.
    • The results suggest that useful approaches for a healthy work environment could be to address issues of organisational virtuousness, employee commitment and joy at work.
  • 35.
    Areskoug Josefsson, Kristina
    et al.
    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). Department of Behavioural Sciences, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway, and Faculty of Health Studies, VID Specialized University, Sandnes, Norway..
    Hjalmarsson, Sara
    Swedish Rheumatism Association, Norrköping, Sweden.
    Björk, Mathilda
    Division of Occupational Therapy, Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Sverker, Anette
    Department of Activity and Health, Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Co-creation of a working model to improve sexual health for persons living with rheumatological diseases2020In: Open Journal of Rheumatology and Autoimmune Diseases, ISSN 2163-9914, Vol. 10, no 3, p. 109-124Article in journal (Refereed)
    Abstract [en]

    Background: Sexual health needs are insufficiently met for persons living with rheumatological diseases and it is necessary to create better ways to meet these needs. 

    Objective: To co-create a working model to improve sexual health for persons living with rheumatological diseases, that can be used by rheumatological teams in regular rheumatology practice. 

    DesignThis study applied a co-creation design with three key features: 1) it took a systems perspective with emergent multiple interactive entities; 2) the research process was viewed as a creative endeavour with strong links to design, while human imagination and the individual experience of patient and staff were at the core of the creative design effort; 3) the process of the co-creative efforts was as important as the generated product. 

    Results: A model defining the role of the patient, the professionals, and the team in optimizing sexual health for persons living with rheumatological diseases was co-created. The model can be seen as a practice guideline, which includes the support needed from and to each participant in the process of promoting sexual health, while being within the professional scope of the professionals’ knowledge and capacity, and in line with the needs of the persons living with rheumatological diseases. 

    Discussion and Conclusions: The co-creative work process identified crucial factors in promoting sexual health, resulting in a useful model for patients, professionals and teams. Co-creation was experienced to be a useful research design to improve rheumatological care, through valuing and using the competence of all research members equally.

  • 36.
    Areskoug Josefsson, Kristina
    et al.
    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). VID Specialized University, Stavanger, Norway.
    Nordin, Annika
    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).
    Kjellström, Sofia
    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).
    Trust and self-efficacy as enablers and products of co-production in health and welfare services2021In: Processual perspectives on the co-production turn in public sector organizations / [ed] Anja Overgaard Thomassen & Julie Borup Jensen, Hershey, PA: IGI Global, 2021, p. 42-58Chapter in book (Refereed)
    Abstract [en]

    Health and welfare services are facing major challenges, including impaired efficiency in meeting the complex needs of users. To face these challenges, there is a need to develop new ways of working, such as co-production. It is a challenge to enable and enhance inclusive co-productive processes, but trust and self-efficacy are key concepts for success. Trust and self-efficacy can be considered as both enablers and products of co-production and are thus important to acknowledge together with contextual factors and to act upon at all organizational levels, starting with individual patients and users.

  • 37.
    Areskoug Josefsson, Kristina
    et al.
    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).
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden.
    Value of performing a Rasch analysis on a reliable and valid instrument: Case study of the SA-SH2020In: Journal of Nursing Measurement, ISSN 1061-3749, E-ISSN 1945-7049, Vol. 28, no 2, p. 322-342Article in journal (Refereed)
    Abstract [en]

    Background and Purpose

    The aim of this study was to explore the potential added value of performing a Rasch analysis on a reliable and valid instrument employed in nursing research and educational interventions, using the Students' Attitudes toward Sexual Health (SA-SH) as an example.

    Methods

    This study was performed with a polytomous Rasch model.

    Results

    The Rasch analysis confirmed the reliability and validity of the SA-SH. Rasch analysis presented information about the item's individual response options and gave the opportunity to judge how well different answers alternated in an item. The Rasch analysis also provided information about the proportion of extremes and the possibility of excluding these.

    Conclusions

    The Rasch analysis provides added value regarding information that needs to be considered regarding choices of questionnaire literacy compared to item fit. The SA-SH is also valid and reliable when tested with Rasch analysis.

  • 38.
    Aronsson, Frida
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Johansson, Sofia
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Organisatoriskt lärande för att öka vårdkvalitet: Lärdomar av att utveckla processledning vid en operations- och intensivvårdsklinik2018Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [en]

    Background: Complex organizations need to be patient centred, focus on processes, have holistic view and promote organizational learning to secure quality. Operation and intensive care unit, Ryhov, has potential to develop its Process Management (PM) and there is room for improved patient participation.

     

    Purpose: The purpose of the quality improvement project (QIP) was to identify and reduce quality gaps affecting patients, by develop PM and organizational learning. The purpose of the study was to describe co-workers’ understanding of the connection between PM and quality of care and describe their experiences from QIP.

     

    Methods: The QIP has developed organizational learning concerning two pilot processes by using Nolan’s model for improvement. The study of the QIP is qualitative, based on six focus group interviews. Qualitative content analysis was used to analyse the interviews.

     

    Results: PM demands access to improvement and professional knowledge. The organization need to create conditions for sustainability, make benefits obvious and ensure enough resources. Quality of care increases when the organization works structured and patient centred.

     

    Conclusions: PM creates conditions for continual improvements with focus on organizational learning and increased quality of care. The organization need to actively make PM an integral and living part.

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  • 39.
    Arvidsson, Eva
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Research and Development unit for Primary Care, Futurum, Jönköping, Sweden.
    Health care quality indicators in the context of primary health care: Healthy practices, healthy professionals and healthy patients2019Conference paper (Refereed)
  • 40.
    Arvidsson, Eva
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköpings Län.
    PrimärvårdsKvalitet – en hjälp att diagnostisera och behandla "lagom"2019Conference paper (Refereed)
  • 41.
    Arvidsson, Eva
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Research and Development unit for Primary Care, Futurum, Jönköping, Sweden.
    Quality Indicators and the relevance of Indicators in General Practice: How to conceive and execute?2019Conference paper (Refereed)
  • 42.
    Arvidsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköping County, Sweden.
    Dahlin, Sofia
    Futurum, Region Jönköping County, Sweden.
    Anell, Anders
    Lund University School of Economics & Management, Lund, Sweden.
    Conditions and barriers for quality improvement work: a qualitative study of how professionals and health centre managers experience audit and feedback practices in Swedish primary care2021In: BMC Family Practice, E-ISSN 1471-2296, Vol. 22, article id 113Article in journal (Refereed)
    Abstract [en]

    Background: High quality primary care is expected to be the basis of many health care systems. Expectations on primary care are rising as societies age and the burden of chronic disease grows. To stimulate adherence to guidelines and quality improvement, audit and feedback to professionals is often used, but the effects vary. Even with carefully designed audit and feedback practices, barriers related to contextual conditions may prevent quality improvement efforts. The purpose of this study was to explore how professionals and health centre managers in Swedish primary care experience existing forms of audit and feedback, and conditions and barriers for quality improvement, and to explore views on the future use of clinical performance data for quality improvement.

    Methods: We used an explorative qualitative design. Focus groups were conducted with health centre managers, physicians and other health professionals at seven health centres. The interviews were audio recorded, transcribed and analysed using qualitative content analysis.

    Results: Four different types of audit and feedback that regularly occurred at the health centres were identified. The main part of the audit and feedback was “external”, from the regional purchasers and funders, and from the owners of the health centres. This audit and feedback focused on non-clinical measures such as revenues, utilisation of resources, and the volume of production. The participants in our study did not perceive that existing audit and feedback practices contributed to improved quality in general. This, along with lack of time for quality improvement, lack of autonomy and lack of quality improvement initiatives at the system (macro) level, were considered barriers to quality improvement at the health centres.

    Conclusions: Professionals and health centre managers did not experience audit and feedback practices and existing conditions in Swedish primary care as supportive of quality improvement work. From a professional perspective, audit and feedback with a focus on clinical measures, as well as autonomy for professionals, are necessary to create motivation and space for quality improvement work. Such initiatives also need to be supported by quality improvement efforts at the system (macro) level, which favour transformation to a primary care based system.

  • 43.
    Arvidsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Region Jönköping County.
    Dahlin, Sofie
    Region Östergötland.
    Quality improvement in daily work in primary care2019Conference paper (Refereed)
    Abstract [en]

    Primary health centres (PHCs) nowadays have access to data feed-back through different sources. However, while some HCSs are constantly running improvement projects others don’t use feed-back data. A national system for the audit and feed-back, Primary Care Quality, is now introduced in Sweden. Increased knowledge aboutthe reasons behind the different use of audit and feed-back data at different PHCs would be helpful help to improve conditions for use of data for quality improvement. Focus group interviews were conducted with staff and management teams at primary care centres in Sweden during. Data was analysed using qualitative content analysis. Preliminary results are three main themes that describes different approaches to quality improvement in daily practice. Each theme represents a quality improvement strategy with specifik characteristics. The three themes can be described on an axis from simple to complicated to complex.

  • 44.
    Arvidsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Research and Development unit for Primary Care, Futurum, Jönköping, Sweden.
    Elmroth, Ulrika
    SALAR, Stockholm, Sweden.
    Quality indicators – sometimes useful sometimes not!2019Conference paper (Refereed)
    Abstract [en]

    Quality indicators can be very useful as a starting point for quality improvement work. However, using quality indicators for pay for performance, seems to have mainly negative consequences. In order to clarify this EQuiP updated their policy paper on quality indicators, which was recently endorsed by Wonca Europe. The positive side of indicators, using them for quality improvement, is exemplified by ”Primary Care Quality”, a Swedish system for quality improvement in primary care.

    In this workshop, a brief background to EQuiP’s policy paper is presented. Thereafter ”Primary Care Quality” is introduced.

    Together, the participants will discuss different use of quality indicators with focus on How the Position paper can be applied in their context How indicators for quality improvement can help quality improvement (by testing ”cases” from Swedish health care centres).

    Finally, we summarize our experience of working with quality indicators and discuss what we can do to facilitate the positive use of them.

  • 45.
    Arvidsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. R&D unit for Primary Care, Futurum, Jönköping, Sweden.
    Kovar, Jan
    EQuiP, Czech Republic.
    Matusova, Maria
    EQuiP, Slovakia.
    Rochfort, Andrée
    Irish College of General Practitioners, Dublin, Ireland, EQuiP.
    Quality indicators: From useless to useful2020In: The world book of family medicine, Ljubljana: World Organization of Family Doctors - Europe (WONCA Europe) , 2020, Europe Edition, p. 60-62Chapter in book (Refereed)
  • 46.
    Arvidsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Research and Development unit for Primary Care, Futurum, Jönköping, Sweden.
    Rochfort, A.
    Matusova, M.
    Kovar, J.
    Quality indicators: From Worthless to Useful2019Conference paper (Refereed)
  • 47.
    Asif, M.
    et al.
    Department of Statistics, Govt. Degree College Qadir Pur Raan, Multan, Pakistan.
    Aslam, M.
    Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan.
    Qasim, Muhammad
    Jönköping University, Jönköping International Business School, JIBS, Economics, Finance and Statistics.
    Altaf, S.
    Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan.
    Ismail, A.
    Institute of Food Science and Nutrition, Faculty of Agricultural Sciences, Bahauddin Zakariya University, Multan, Pakistan.
    Ali, H.
    Department of Zoology, Govt. Degree College Qadir Pur Raan, Multan, Pakistan.
    A dataset about anthropometric measurements of the Pakistani children and adolescents using a cross-sectional multi-ethnic anthropometric survey2021In: Data in Brief, E-ISSN 2352-3409, Vol. 34, article id 106642Article in journal (Refereed)
    Abstract [en]

    Evaluation of nutritional status is necessary during childhood and the juvenile years when the level of hydration and the adipose tissues experience significant changes. Anthropometric measurements and their derived indices are valid proxies to predict body fat, obesity (general or central) and their associated cardiovascular risks. The dataset under consideration also provides the socio-demographic related information and anthropometric measurement values related to height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HpC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), mid-upper arm circumference (MUAC), neck circumference (NC), and wrist circumference (WrC). Standard procedure was adopted for quantifying the body measurements. The data were consisting of 10,782 children and adolescents aged 2–19 years, belonging four major cities of Pakistan viz. Multan, Lahore, Rawalpindi and Islamabad. This dataset is beneficial to develop anthropometric growth charts which will provide the essential knowledge of growth and nutritional disorders (e.g., stunted, overweight and obesity) of Pakistani children and adolescents. The dataset can also be used by researchers to calculate body surface area (BSA), body frame size (BFS), body shape index (BSI), and tri-ponderal mass index (TMI) of children and adolescents that are also some other reliable indicators of obesity and insulin resistance as well as cardiometabolic risk in children and adults.

  • 48.
    Avby, Gunilla
    et al.
    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).
    Kjellström, Sofia
    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).
    ”Inga bevis för att chefer blir bättre av att gå på kurs”2020In: Dagens Nyheter, ISSN 1101-2447, no 2021-04-22Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Ingress: 

    Två forskare: Risken är att cheferna efter en kurs får en mer idealiserad bild av sin roll som inte stämmer med vardagens verklighet.

    En vanligt förekommande uppfattning är att chefer och ledare utvecklas bäst genom att gå på kurs. Men det finns ingen evidens för att det är det bästa sättet att utveckla ledarskapets kompetens.

  • 49.
    Avby, Gunilla
    et al.
    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).
    Kjellström, Sofia
    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).
    Innovationskraft i vardagens processer2020In: Chefer och ledare i vården, ISSN 1404-4684, no 4, p. 24-27Article in journal (Other academic)
    Abstract [sv]

    Forskningen visar återkommande att 70 procent av olika typer av utvecklingssatsningar misslyckas. Särskilt utmanande blir det i komplexa organisationer. Hur ser innovationsklimatet ut i din verksamhet? Och vad säger forskningen om att leda innovation och förändring?

  • 50.
    Avby, Gunilla
    et al.
    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).
    Kjellström, Sofia
    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).
    LearnOvation: an intervention to foster exploration and exploitation behaviour in health care management in daily practice2019In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, no 1, article id 319Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Innovation has been identified as an important engine for improving the quality, productivity and efficiency of health care. Little is known about how to stimulate innovation capacity in primary health care in general; even less is known about how specific interventions should be designed to support managements' work with practice-based innovations. Research has shown that if managers and teams are excellent at handling the challenges of production (exploitation) and development (exploration), they are better at innovation. The aim of the study is to develop a dynamic management support programme to increase innovation leadership skills in daily practice.

    METHODS: The study has an interactive approach that allows the need for empirical and theoretical knowledge to emerge and merge, and a quasi-experimental cross-over design. Eight primary health care centres will participate in the study. In the first phase, the management teams at four health care centres will participate in the intervention, and the other four centres will serve as a control group. Thereafter, the units will switch places and the control group will experience the intervention. All staff at the 8 units will answer questionnaires at four points in time (before, during, after, 6 months later) to evaluate the effects of the intervention.

    DISCUSSION: The study will contribute to knowledge on how to organize processes of innovation and support exploitation and exploration behaviours by co-producing and testing a tailor-made management support programme for innovation work in primary health care. An expected long-term effect is that the support system will be disseminated to other centres both within and beyond the participating organizations.

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