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  • 1.
    Acheampong, Faustina
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik. Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Centre for Information Technology and Information Systems (CenITIS). Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Innovating healthcare through remote monitoring: Effects and business model2017Ingår i: Health Care Delivery and Clinical Science: Concepts, Methodologies, Tools, and Applications, IGI Global, 2017, s. 247-268Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    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
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, 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 care2018Ingår i: Health, ISSN 1363-4593, E-ISSN 1461-7196, Vol. 22, nr 6, s. 603-623Artikel i tidskrift (Refereegranskat)
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan.
    Integrating improvement learning into health professional educational curricula2008Ingår i: International Forum on Quality Improvement in Healthcare, France, April 24 2008: International Forum on QI , 2008, s. 1-Konferensbidrag (Refereegranskat)
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, 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 patients2015Ingår i: Procedia Computer Science, E-ISSN 1877-0509, Vol. 64, s. 118-124Artikel i tidskrift (Refereegranskat)
    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
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Impact of a nationwide government program in Sweden on how healthcare managers, in their organisations, manage the work with sickness certification of patients2014Ingår i: The European journal of public health, Vol. 24, Supplement 2, 2014, s. 90-Konferensbidrag (Refereegranskat)
  • 6.
    Algurén, Beatrix
    et al.
    Högskolan i Jönköping, Hälsohögskolan, 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
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Region Jönköping County, Futurum, Sweden.
    Thor, Johan
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson, Ann-Christine
    Högskolan i Jönköping, Hälsohögskolan, 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 Sweden2018Ingår i: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 30, nr 10, s. 786-792Artikel i tidskrift (Refereegranskat)
    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, Hälsohögskolan, 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, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, 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, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, 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 scales2020Ingår i: Journal of Patient-Reported Outcomes, ISSN 2509-8020, Vol. 4, nr 1, artikel-id 7Artikel, forskningsöversikt (Refereegranskat)
    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, Hälsohögskolan, 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 care2021Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 16, nr 1, artikel-id e0244874Artikel i tidskrift (Refereegranskat)
    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.
    Högskolan i Jönköping, Hälsohögskolan, 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
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Futurum, Region Jönköping County, Jönköping, Sweden.
    Peterson, Anette
    Högskolan i Jönköping, Hälsohögskolan, 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 time2019Ingår i: Implementation Science, E-ISSN 1748-5908, Vol. 14, nr 1, artikel-id 74Artikel i tidskrift (Refereegranskat)
    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, Högskolan för lärande och kommunikation.
    Participation in Outside Home Activities in China: A comparison of Typically Developing Children and Children with Developmental Disabilities2021Självständigt arbete på avancerad nivå (masterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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, Tekniska Högskolan, JTH, Logistik och verksamhetsledning. Jönköping University, Hälsohögskolan, 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’2019Ingår i: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 31, nr 8, s. G87-G96Artikel i tidskrift (Refereegranskat)
    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
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    How to reach effective health service delivery?2017Ingår i: Journal of General Practice, ISSN 2329-9126, Vol. 5, nr 4, artikel-id 1000320Artikel i tidskrift (Refereegranskat)
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  • 13.
    Andersson, Ann-Christine
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kvalitetsarbete inom omvårdnad – förbättringskunskap och ständiga förbättringar2018Ingår i: Kvalitetsutveckling inom omvårdnad: sjuksköterskans professionella ansvar / [ed] A. Hommel & Å. Andersson, Lund: Studentlitteratur AB, 2018, s. 45-68Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 14.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, 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 housing2016Ingår i: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 25, nr 1, s. 44-52Artikel i tidskrift (Refereegranskat)
    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.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Thor, Johan
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Lenrick, Raymond
    Rapport om utvärdering av IVO:s lärande tillsyn2018Rapport (Övrigt vetenskapligt)
    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.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Golsäter, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Melke, Anna
    Erfarenheter från lärandeseminarier: Barn som anhöriga: Reflektioner från följeforskning2016Rapport (Övrigt vetenskapligt)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Golsäter, Marie
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. CHILD.
    Andersson-Gäre, Boel
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Melke, Anna
    Jönköping University, Hälsohögskolan, 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 context2020Ingår i: International Journal of Healthcare Management, ISSN 2047-9700, E-ISSN 2047-9719, Vol. 13, nr 3, s. 236-244Artikel i tidskrift (Refereegranskat)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Göteborg Region Association of Local Authorities, Gothenburg, Sweden.
    Andersson Gäre, Boel
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Golsäter, Marie
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, 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 support2018Ingår i: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 27, nr 3, s. 172-177Artikel i tidskrift (Refereegranskat)
    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
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Avby, Gunilla
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Identity work of successful primary care managers and competing institutional logics2017Konferensbidrag (Refereegranskat)
  • 20.
    Andersson Bäck, Monica
    et al.
    University of Gothenburg.
    Kjellström, Sofia
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Avby, Gunilla
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Medical manager hybrids for handling institutional complexity and change in primary care2017Konferensbidrag (Refereegranskat)
    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 stöd2021Självständigt arbete på grundnivå (yrkesexamen), 20hpStudentuppsats (Examensarbete)
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  • 22.
    Andersson, Karolina
    Jönköping University, Hälsohögskolan, 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 hjärtsvikt2021Självständigt arbete på avancerad nivå (masterexamen), 80 poäng / 120 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Patienter med kronisk hjärtsvikt står för hälften av alla internmedicinska slutenvårdstillfällen på Södertälje sjukhus. Då ett av symtomen är andnöd söker patienterna ofta vården i ett akut skede med oro och ångest. Genom att ge förutsättningar för patienter att lära känna, och vara delaktiga i vården av, sin hjärtsvikt, kan försämring förebyggas vilket minskar behovet av att söka vård akut. Dessa förutsättningar kan skapas med hjälp av teknik där patienter själva mäter blodtryck, vikt etc. och sätta dessa mätresultat i relation till sina levnadsvanor. Egenmonitorering förväntas minska behovet av inneliggande sjukhusvård, minska fysiska vårdbesök, förbättra hälsoutfall och ge ökad trygghet för personer med hjärtsvikt och deras närstående. För att ytterligare stärka patientens egenvård, genom support, finns personal på mottagningen som kan se patientens mätvärden via en teknisk plattform där kommunikationen också sker. Det övergripande syftet med aktuellt förbättringsarbete var att testa ny teknik och nya arbetssätt för patienter med hjärtsvikt och samla insikter samt erfarenheter inför ett eventuellt breddinförande. Målet var att 10 patienter med hjärtsvikt före 2021-03-31 hade medverkat i pilottest av egenmonitorering. Examensarbetet syftar till att med stöd av ett teoretiskt ramverk klarlägga vilka förhållanden som påverkar övergången från traditionell slutenvård till egenmonitorering för personer med hjärtsvikt. Förbättringsarbetet resulterade i att åtta patienter från två olika verksamhetsområden inkluderades. Studien visade bland annat att innan en organisation ska införa egenmonitorering bör hänsyn tas till komplexiteten i hälso- och sjukvården. Goda infrastrukturer för IT är avgörande och tekniken behöver bli mer flexibel för att patienter som inte har svenska som språk ska kunna få ta del av egenmonitorering

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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, Internationella Handelshögskolan, IHH, Nationalekonomi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Workplace accidents and workers’ solidarity: mutual health insurance in early twentieth-century Sweden2022Ingår i: Economic history review, ISSN 0013-0117, E-ISSN 1468-0289, Vol. 75, nr 1, s. 203-234Artikel i tidskrift (Refereegranskat)
    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 flödesperspektiv2023Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    SAMMANFATTNINGSyfte – Kvaliteten i hälso- och sjukvården är bristande, och en ökad relationskontinuitet kan bidra till samt vara en förutsättning för att öka kvaliteten. Trots kunskapen om relationskontinuitetens goda effekter, finns ett kunskapsgap i vad det är som inte fungerar för att uppnå den. Därmed är studiens syfte:

    Att undersöka barriärer och möjligheter för relationskontinuitet i hälso- och sjukvårdens patientflöden.

    Metod – Studien är en fallstudie som kombinerar både kvalitativ samt kvantitativa data. Studien inleddes med en förstudie som inkluderade litteraturstudier samt dialoger med verksamheten. För att samla in data användes datainsamlingsteknikerna dokumentstudie, observation och intervju. Den insamlade data analyserades kontinuerligt under studiens gång och jämfördes samt stärktes av teori för att säkerställa studiens validitet. För att öka validiteten betraktades även triangulering som en väsentlig del av studien.

    Resultat – Studiens resultat visar att förekomsten av relationskontinuitet ses skilja mellan ambition och förmåga, då ambitionen är hög och förmågan är låg. Vidare identifierades barriärerna för relationskontinuitet som en bristande tillgänglighet, hälso- och sjukvårdens IT-system och idén av fast läkare som enskild lösning för att upprätthålla relationskontinuiteten. Ytterligare barriärer som identifierades var akuta fall samt tidsaspekten. Utifrån barriärerna har förbättringsförslag tagits fram, genom förändringar som borde ske långsiktigt men också hur arbetet för relationskontinuitet kan förbättras genom de befintliga förutsättningarna.

    Implikationer – Utifrån studiens resultat har teoretiska och praktiska implikationer tagits fram. En ny dimension av befintlig teori har upptäckts, som menar på att flödeseffektivitet kan leda till relationskontinuitet. Genom detta har det även konstaterats att flödesperspektivet kan ge goda effekter i hälso- och sjukvården. Det har bekräftats att relationskontinuiteten är bristande, samt erhållits djupare förståelse kring orsakerna för detta. Praktiska implikationer har erhållits i form av de förbättringsförslag som tagits fram i resultatet.

    Begränsningar – Fallstudien är utformad som en enfallsdesign, vilket begränsar studiens generaliserbarhet då endast en analysenhet har studerats. Det har under studiens gång observerats att det förekommer felregistreringar i hälso- och sjukvårdens IT-system. Data från dokumentstudie har hämtats från detta system, vilket resulterar i en begränsning av tillförlitligheten i den data. Ytterligare en begränsning är att studien genomförts under en begränsad tidsperiod.

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  • 25.
    Andersson, T.
    et al.
    School of Business, University of Skövde, Skövde, Sweden.
    Linnéusson, Gary
    Jönköping University, Tekniska Högskolan, JTH, Industriell produktutveckling, produktion och 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 study2022Ingår i: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 37, nr 9, s. 17-33Artikel i tidskrift (Refereegranskat)
    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, Internationella Handelshögskolan, IHH, Företagsekonomi. Jönköping University, Internationella Handelshögskolan, IHH, Media, Management and Transformation Centre (MMTC).
    Clinicians' psychological empowerment to engage in management as part of their daily work2023Ingår i: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 36, nr 9, s. 272-287Artikel i tidskrift (Refereegranskat)
    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, Internationella Handelshögskolan, IHH, Redovisning, Marknadsföring, SCM, Informatik och Rättsvetenskap.
    Patients' perceptions of quality in Swedish primary care - a study of differences between private and public ownership2021Ingår i: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 35, nr 9, s. 85-100Artikel i tidskrift (Refereegranskat)
    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, Hälsohögskolan, 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 practices2024Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, nr 1, artikel-id 33Artikel i tidskrift (Refereegranskat)
    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
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    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.2019Självständigt arbete på avancerad nivå (masterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund Malnutrition är associerad med en förändring av livskvalitén, depressioner, förlängd sjukhusvistelse och förkortad överlevnad. Den här masteruppsatsen beskriver studien av ett förbättringsarbete drivet av ett förbättringsteam på två avdelningar som vårdar patienter med hematologiska, onkologiska och lungsjukdomar.

    Syfte Syftet med förbättringsarbetet är att förbättra hälsotillståndet genom förbättrad nutritionsprocess. Syftet med studien av förbättringsarbetet är att beskriva hur förbättringsteamet genom sitt arbete skapar engagemang på avdelningen.

    Metod Förbättringsarbetet har drivits med hjälp av Nolans förbättringsmodell, PDSA-cykler samt kartläggning av mikrosystemet utifrån 5P-modellen. En fallstudie har genomförts som inkluderar semistrukturerade intervjuer med efterföljande innehållsanalys samt enkäter med kvantitativa resultat.

    Resultat Förbättringsarbetets resultat visar på att fler energiregistreringar genomförs, men ännu ses ingen påverkan på det dagliga energiintaget. Resultatet av innehållsanalysen beskriver hur förbättringsteamet har påverkat förbättringsarbetet utifrån tre följande tema: existens och dynamik, individanpassad vägvisare samt delad förståelse för målet.

    Slutsats Studien av förbättringsarbetet visar att förbättringsarbetet har bidragit till en ökad kunskapsnivå inom nutrition både i förbättringsteamet och på avdelningen. Studien visar också att ett dynamiskt förbättringsteam har möjlighet att påverka kulturen på avdelningen genom att öka engagemanget.

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  • 30.
    ARANITI, AIKATERINI
    Jönköping University, Högskolan för lärande och kommunikation.
    Perceptions and Experiences of Social Participation in Physical Activties Among Youths with Physical Disabilities in Greece.: A qualitative Empirical Study2021Självständigt arbete på avancerad nivå (masterexamen), 15 poäng / 22,5 hpStudentuppsats (Examensarbete)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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 rehabilitation2021Konferensbidrag (Refereegranskat)
  • 32.
    Areskoug Josefsson, Kristina
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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!2021Konferensbidrag (Refereegranskat)
  • 33.
    Areskoug Josefsson, Kristina
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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 health2021Ingår i: Cogent Medicine, E-ISSN 2331-205X, Vol. 8, nr 1Artikel i tidskrift (Refereegranskat)
    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.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Avby, Gunilla
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Andersson Bäck, Monica
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Kjellström, Sofia
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, 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 study2018Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, nr 4, s. 406-414Artikel i tidskrift (Refereegranskat)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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 diseases2020Ingår i: Open Journal of Rheumatology and Autoimmune Diseases, ISSN 2163-9914, Vol. 10, nr 3, s. 109-124Artikel i tidskrift (Refereegranskat)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). VID Specialized University, Stavanger, Norway.
    Nordin, Annika
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, 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 services2021Ingår i: Processual perspectives on the co-production turn in public sector organizations / [ed] Anja Overgaard Thomassen & Julie Borup Jensen, Hershey, PA: IGI Global, 2021, s. 42-58Kapitel i bok, del av antologi (Refereegranskat)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Rolander, Bo
    Jönköping University, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). 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-SH2020Ingår i: Journal of Nursing Measurement, ISSN 1061-3749, E-ISSN 1945-7049, Vol. 28, nr 2, s. 322-342Artikel i tidskrift (Refereegranskat)
    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.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Johansson, Sofia
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Organisatoriskt lärande för att öka vårdkvalitet: Lärdomar av att utveckla processledning vid en operations- och intensivvårdsklinik2018Självständigt arbete på avancerad nivå (masterexamen), 80 poäng / 120 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Komplexa verksamheter måste fokusera på processerna, ett organisatoriskt helhetsperspektiv och lärande samt ha patienten i centrum för att säkra vårdkvaliteten. På Operations- och intensivvårdskliniken, Ryhov, har processarbete påbörjats men utvecklingspotential finns samt utrymme för tydligare rutiner gällande patientdelaktighet.

     

    Syfte: Förbättringsarbetets syfte var att identifiera och minska kvalitetsgap i verksamheten som påverkar patienten, genom att utveckla klinikens processledning och det organisatoriska lärandet. Studiens syfte var att beskriva medarbetarens uppfattning om processledningens koppling till vårdkvalitet, samt beskriva deras erfarenheter från processledningsutvecklingsarbetet.

     

    Metod: Förbättringsarbetet har i projektgruppsformat och med Nolans förbättringsmodell utvecklat det organisatoriska lärandet kring två pilotprocesser. Studien av förbättringsarbetet är kvalitativ och baseras på sex fokusgruppsintervjuer. Intervjumaterialet analyserades med hjälp av kvalitativ innehållsanalys med induktiv ansats.

     

    Resultat: Processledning kräver tillgång till förbättrings- och yrkeskompetens. Organisationen måste ge förutsättningar för en varaktighet där nyttan är tydlig och resurser är tillräckliga. Vårdkvaliteten ökar när organisationen arbetar strukturerat, personcentrerat och med patientsäkerhet som fokus.

     

    Slutsatser: Processledning kan ge organisationen förutsättningar att skapa kontinuerlig förbättring med fokus på organisatoriskt lärande och ökad vårdkvalitet för patienten. Organisationen måste arbeta aktivt för att göra detta till en integrerad och levande del av verksamheten.

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  • 39.
    Arvidsson, Eva
    Högskolan i Jönköping, Hälsohögskolan, 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 patients2019Konferensbidrag (Refereegranskat)
  • 40.
    Arvidsson, Eva
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköpings Län.
    PrimärvårdsKvalitet – en hjälp att diagnostisera och behandla "lagom"2019Konferensbidrag (Refereegranskat)
  • 41.
    Arvidsson, Eva
    Högskolan i Jönköping, Hälsohögskolan, 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?2019Konferensbidrag (Refereegranskat)
  • 42.
    Arvidsson, Eva
    et al.
    Jönköping University, Hälsohögskolan, 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 care2021Ingår i: BMC Family Practice, E-ISSN 1471-2296, Vol. 22, artikel-id 113Artikel i tidskrift (Refereegranskat)
    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.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Region Jönköping County.
    Dahlin, Sofie
    Region Östergötland.
    Quality improvement in daily work in primary care2019Konferensbidrag (Refereegranskat)
    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.
    Högskolan i Jönköping, Hälsohögskolan, 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!2019Konferensbidrag (Refereegranskat)
    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, Hälsohögskolan, 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 useful2020Ingår i: The world book of family medicine, Ljubljana: World Organization of Family Doctors - Europe (WONCA Europe) , 2020, Europe Edition, s. 60-62Kapitel i bok, del av antologi (Refereegranskat)
  • 46.
    Arvidsson, Eva
    et al.
    Högskolan i Jönköping, Hälsohögskolan, 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 Useful2019Konferensbidrag (Refereegranskat)
  • 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, Internationella Handelshögskolan, IHH, Nationalekonomi, Finansiering och Statistik.
    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 survey2021Ingår i: Data in Brief, E-ISSN 2352-3409, Vol. 34, artikel-id 106642Artikel i tidskrift (Refereegranskat)
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    ”Inga bevis för att chefer blir bättre av att gå på kurs”2020Ingår i: Dagens Nyheter, ISSN 1101-2447, nr 2021-04-22Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    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, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Innovationskraft i vardagens processer2020Ingår i: Chefer och ledare i vården, ISSN 1404-4684, nr 4, s. 24-27Artikel i tidskrift (Övrigt vetenskapligt)
    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.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kjellström, Sofia
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, 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 practice2019Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, nr 1, artikel-id 319Artikel i tidskrift (Refereegranskat)
    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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