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  • 201.
    Wass, Sofie
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    The importance of eHealth innovations: Lessons about patient accessible information2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Access to digital information and communication has an increasing importance in both the work of healthcare professionals and in patients’ everyday life and has transformed what we do and how we carry out activities. It changes the way in which healthcare is delivered, how information is exchanged within and between organizations and how patients and other actors access and manage information. Currently, innovation is imperative in the healthcare sector and today there is a focus on how different eHealth services can improve healthcare. With increased access to various eHealth services, there is a need to know more about the impact of eHealth innovations on healthcare.

    The aim of this thesis is to acquire more knowledge about eHealth innovations in healthcare. The focus is on prerequisites to realize innovative eHealth services and eHealth services that provide patients with access to health information. The theoretical background addresses innovation, services and business models. This thesis is a compilatory work and includes five qualitative research papers. The first study is an interview study, the second is a literature review and the remaining three are case studies. The data collection consisted of interviews, surveys, workshops and secondary data collected from documents. The interview study and the case studies were performed in the Swedish eHealth setting.

    The research contributes to our understanding of eHealth innovations with insights on prerequisites to realize eHealth innovations and knowledge on patient accessible information. The first study provides a classification of prerequisites that need to be considered to realize innovative eHealth services. When dealing with eHealth services, organizational and sematic interoperability are still a challenge, and they transcend organizational boundaries. This thesis provides knowledge on the recent trend of opening up electronic health records to patients. The knowledge derived from the studies on patient accessible electronic health records show that there is a discrepancy between the perceptions of patients and healthcare professionals. The thesis concludes that patients feel more involved and that the patient-professional relationship improves with patient access to electronic health records, whereas healthcare professionals have concerns about how patients will manage access to health information. This thesis also provides empirical insights on how business models can be represented in a public eHealth setting. By viewing public eHealth services as social innovations, the thesis contributes to the research on business models in a public healthcare setting by incorporating societal value into the representation of the business model.

    The research in this thesis contributes to research in health informatics by discussing issues related to eHealth innovations and patient accessible information. Its practical importance lies in identifying issues that are important when discussing eHealth initiatives and the implications of giving patients online access to their electronic health record.

  • 202.
    Wass, Sofie
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Carlsson, Bertil
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Vimarlund, Vivian
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Korkmaz, Seher
    E-health and Strategic IT, Public Health Care Administration, Stockholm County Council, Stockholm, Sweden.
    Shemeikka, Tero
    E-health and Strategic IT, Public Health Care Administration, Stockholm County Council, Stockholm, Sweden.
    Vég, Anikó
    Department of Healthcare Development, Stockholm County Council, Stockholm, Sweden.
    Exploring the effects of eHealth service innovation2015In: Health Systems, ISSN 2047-6965, E-ISSN 2047-6973, Vol. 4, no 3, p. 212-223Article in journal (Refereed)
    Abstract [en]

    To analyse the impact of implementation and use of eHealth services is fraught with difficulty, and there is often a gap between expected and identified outcomes. In this paper, we identify innovation effects of an eHealth service by applying a framework that focusses on the expected coherent impacts of implementing an IT innovation and contributes to the body of knowledge on tracking innovation effects of services in eHealth. A case study examines four different care units in a government-funded health-care setting. The results show that the effects in the first two contexts of the framework, the micro level and intra-/interorganisational level, could be clearly identified with regard to the physicians and the organisation. However, effects were lacking in the virtual context when looking beyond the involvement of the stakeholders in the eHealth service. The connections between effects for societal groups and larger societal systems simply could not be made in a satisfactory manner.

  • 203.
    Wass, Sofie
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Vimarlund, Vivian
    Jönköping University, Jönköping International Business School, JIBS, Informatics. Jönköping University, Jönköping International Business School, JIBS, Centre for Information Technology and Information Systems (CenITIS). Linköping University, Linköping, Sweden.
    Business models in public eHealth2016In: 24th European Conference on Information Systems, ECIS 2016, 2016Conference paper (Refereed)
    Abstract [en]

    Several countries develop strategies and policies to foster the use of eHealth services and stress the importance of business models to develop and implement digital services. Previous research on business models has however mostly focused on the private setting or a healthcare setting with multi-payer or market-based financial systems. In this paper, we explore the use of business models in eHealth as well as the consistency of such a model in a public healthcare setting. The study is performed through a case study of an eHealth service and to which we apply a business model framework. Data have been collected through interviews, documents and project meetings. The results show that all parts of the business model could be identified and provide an overview of the service but no clear guidance on how to reach a sustainable value in the future. It seems that, in the case of public healthcare, there is a need to add the notion of a societal value as well as issues related to future governance for the diffusion of the service to make the business model and the service sustainable.

  • 204.
    Wass, Sofie
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Vimarlund, Vivian
    Jönköping University, Jönköping International Business School, JIBS, Informatics. Jönköping University, Jönköping International Business School, JIBS, Centre for Information Technology and Information Systems (CenITIS). Department of Computer Science, Linköping University, Sweden .
    Healthcare in the age of open innovation – A literature review2016In: Health Information Management Journal, ISSN 1833-3583, E-ISSN 1833-3575, Vol. 45, no 3, p. 121-133Article in journal (Refereed)
    Abstract [en]

    Background: In spite of an increased interest in open innovation and strategies that call for an increased collaboration between different healthcare actors, there is a lack of open innovation research in public contexts.

    Objective: This article presents the results of a review regarding the healthcare sector’s engagement in open innovation as well as constraining factors and positive outcomes of open innovation in healthcare.

    Method: The literature search focused on papers published in English between 2003 and 2014. Based on specified inclusion criteria, 18 articles were included.

    Results: Results reveal that most studies focus on inbound open innovation where external knowledge is integrated with the internal knowledge base at an initial phase of the innovation process. Innovation primarily results in products and services through innovation networks. We also identified constraining factors for open innovation in healthcare, including the complex organizations of healthcare, the need to establish routines for capturing knowledge from patients and clinicians, regulations and healthcare data laws as well as the positive outcome patient empowerment.

    Conclusion: The healthcare sector’s engagement in open innovation is limited, and it is necessary to perform further research with a focus on how open innovation can be managed in healthcare. 

  • 205.
    Wass, Sofie
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Vimarlund, Vivian
    Jönköping University, Jönköping International Business School, JIBS, Informatics. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Linköping University, Sweden.
    Same, same but different: Perceptions of patients’ online access to electronic health records among healthcare professionals2018In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811Article in journal (Refereed)
    Abstract [en]

    In this study, we explore how healthcare professionals in primary care and outpatient clinics perceive the outcomes of giving patients online access to their electronic health records. The study was carried out as a case study and included a workshop, six interviews and a survey that was answered by 146 healthcare professionals. The results indicate that professionals working in primary care perceive that an increase in information-sharing with patients can increase adherence, clarify important information to the patient and allow the patient to quality-control documented information. Professionals at outpatient clinics seem less convinced about the benefits of patient accessible electronic health records and have concerns about how patients manage the information that they are given access to. However, the patient accessible electronic health record has not led to a change in documentation procedures among the majority of the professionals. While the findings can be connected to the context of outpatient clinics and primary care units, other contextual factors might influence the results and more in-depth studies are therefore needed to clarify the concerns.

  • 206.
    Wass, Sofie
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Vimarlund, Vivian
    Jönköping University, Jönköping International Business School, JIBS, Informatics. Jönköping University, Jönköping International Business School, JIBS, Centre for Information Technology and Information Systems (CenITIS). Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Computer and Information Science, Linköping University, Sweden .
    The Role of ICT in Home Care2017In: Context Sensitive Health Informatics: Redesigning Healthcare Work / [ed] Christian Nøhr, Craig E. Kuziemsky, Zoie Shui-Yee Wong, IOS Press, 2017, Vol. 241, p. 153-158Conference paper (Refereed)
    Abstract [en]

    With an ageing population and limited resources, ICT is often mentioned as a solution to support elderly people in maintaining an independent and healthy lifestyle. In this paper, we describe how ICT can support access to information and rationalization of work processes in a home care context. We do this by modelling the workflow and identifying the possible impact of ICT. The results show a complex process and indicate that the available resources are not used in the best possible way. The introduction of ICT could increase patient safety by reducing the risk of misplacing information about the care recipients and at the same time provide real time information about the care recipients’ needs and health at the point of care. However, to rationalize the work processes there is a need to combine ICT with a changed procedure for handling keys.

  • 207.
    Wass, Sofie
    et al.
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Vimarlund, Vivian
    Jönköping University, Jönköping International Business School, JIBS, Informatics. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Computer and Information Science/Human-Centered Systems, Linköping University, Sweden.
    The Role of PAEHRs in Patient Involvement2018In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 42, no 11, article id 210Article in journal (Refereed)
    Abstract [en]

    With increased patient access to data, healthcare services are experiencing change where patients are moving away from being mere passive actors towards becoming more active and involved participants. In this paper, we explore the role of patient accessible electronic health records (PAEHRs) with respect to this increase in patient involvement. The study was performed as a case study and included nine interviews with patients and a survey that was responded to by 56 patients. Our results show that PAEHRs have a role in the enhancement of patient involvement because PAEHRs (i) foster a more balanced relationship between patients and healthcare professionals and (ii) increase access to information.

  • 208.
    Westergren, Robert
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Nasser, Mehdi
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Patient satisfaction and mobility with their assistive device and service2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: To gather knowledge related to patient satisfaction and mobility with lower limb prosthetic and orthotic devices and to investigate satisfaction with services received. Another purpose of this study is to analyze potential differences between orthotic and prosthetic patients in relation to patient satisfaction and mobility.

    Design: Cross-sectional study

    Subjects: 21 participants with a mean age of 58 (SD 16) with an average duration of use of devices of 10 (SD 10) years. 12 out of the 21 participants were orthotic users and 9 were prosthetic users.

    Methods: Patients were asked to complete two questionnaires, one regarding satisfaction with assistive device and service (QUEST 2.0) and one regarding mobility.

    Results: Patients mean score regarding satisfaction with assistive device and service were 4.0 (SD 0.8) and 4.2 (SD 1.0) respectively. 91% reported that they had the ability to walk at least 100 meters with their assistive device. The areas where participants experienced most difficulties were walking on uneven ground (70%), walking up and down a hill (57%) and walking on stairs (57%).

    Conclusion: Overall this study demonstrates that participants were quite satisfied with their assistive device and the service received by the P&O clinic. No statistically significant differences regarding satisfaction with assistive device and service, or mobility, were found between prosthetic and orthotic participants.

  • 209.
    Wiig, Siri
    et al.
    Department of Health Studies, University of Stavanger, N-4036 Stavanger, Norway.
    Aase, Karina
    Department of Health Studies, University of Stavanger, N-4036 Stavanger, Norway.
    von Plessen, Christian
    Department of Health Studies, University of Stavanger, N-4036 Stavanger, Norway.
    Burnett, Susan
    Imperial College, London, St Mary’s Campus, Norfolk Place, London W2 1PG, UK.
    Nunes, Francisco
    ISCTE, Lisboa, Instituto Superior de Ciências do Trabalho e da Empresa (ISCTE), Av.ª das Forças Armadas, Lisbon 1649-026, Portugal.
    Weggelaar, Anne Marie
    Department of Health Policy and Management, Erasmus University Rotterdam, Postbus 1738, 3000 DR Rotterdam, The Netherlands.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Calltorp, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Fulop, Naomi
    Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
    Talking about quality: exploring how ‘quality’ is conceptualized in European hospitals and healthcare systems2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, no 478, p. 1-12Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study.

    METHODS:

    This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics).

    RESULTS:

    The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient-centered care, enough time to talk with patients). Conceptualization varied between micro systems depending on the type of services provided.

    CONCLUSION:

    The quality conceptualization differed across system levels (macro-meso-micro), among professional groups (nurses, doctors, managers), and between the studied micro systems in our ten sampled European hospitals. This entails a managerial alignment challenge translating macro level quality definitions into different local contexts.

  • 210.
    Wijma, Barbro
    et al.
    IKE, Linköpings universitet, Linköping - Genus och medicin Linköping, Sweden.
    Persson, Alma
    Linkopings universitet Tema Genus - Linkoping, Sweden Linkopings universitet Tema Genus - Linkoping, Sweden.
    Ockander, Marlene
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Brüggemann, Jelmer
    Linköpings universitet - Institutionen för TEMA - Teknik och social förändring Linköping, Sweden.
    Kränkningar i vården är vanligt förekommande - viktigt med aktivt arbete mot att patienter kränks [Abuse in healthcare - lessons learned during two decades of research]2019In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, no 3, p. 84-88Article in journal (Refereed)
    Abstract [en]

    Patients' experience of abuse in health care (AHC) is common, and may cause long-lasting suffering. In Sweden, lifetime prevalence is estimated at 20 per cent among female patients and 8 per cent among male patients, and a background of other abuse is a risk factor. Most health care staff have experience of patients who have been abused, but the topic is surrounded by silence from both patients and caregivers. Models for training staff in groups have been evaluated and a more proactive stance can be fostered. Department heads and health care authorities are responsible for providing staff with options to counteract AHC. Caregivers need training in how to carry out consultations with patients who say they have been abused in health care, and this training should be included in efforts to increase quality of care. Changes are within reach but educational efforts are urgent.

  • 211.
    Williamsson, Anna
    et al.
    Department of Biomedical Engineering and Health Systems, KTH - Royal Institute of Technology, Stockholm, Sweden.
    Dellve, Lotta
    Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.
    Karltun, Anette
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Nurses' use of visual management in hospitals: A longitudinal, quantitative study on its implications on systems performance and working conditions2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to examine potential benefits provided by daily visual management tool use and explore its association with systems performance and working conditions among hospital nurses.

    BACKGROUND: Visual management tools used in everyday work and improvement work in health care theoretically contribute to shared understanding of complex work systems and provide certain user benefits. Cognitive load, miscommunication within and between professional groups, and pressure to engage in care process redesign add to nurses' strained working conditions.

    DESIGN: Quantitative longitudinal.

    METHODS: Questionnaires were distributed at T0, (N = 948, 66% response rate), T1 (N = 900, 70% response rate), and T2 (N = 621, 72% response rate) to nurses at five hospitals. Three groups of users (daily users, start users, and non-daily users) were compared by means T1-T2 (significance tested with Wilcoxon signed rank test) and by mixed model repeated measures T0, T1, T2.

    RESULTS: Daily use associated to better overview of work, collaboration, social capital, and clinical engagement. Job resources were rated higher by daily users. Mental stress increased and development opportunities decreased over time among non-daily users. There were associations between use and perceptions of systems performance, though the differences between groups were small.

    CONCLUSION: This study specifically explores visual management tool use in the hospital setting, which contributes to research by broadening the understanding of cognitive, social, and emotional benefits provided by visual management tool use. Daily use was associated to positive working conditions, small but positive differences in systems performance, and indicated a buffering effect on nurses' mental stress.

  • 212.
    Winberg, Anette
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Användbar och tillgänglig webbkatalog för habiliteringens kursutbud: Ett förbättringsarbete för tillgänglig webbkatalog och en studie av vilka faktorer som har betydelse för hur den används2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background

    Knowledge about one's current disability and its consequences makes everyday life easier. The habilitation center offers approximately fifty courses each semester. The program was recently digitized which decreased costs and administration time and expected to increase accessibility and user-friendliness. Target groups and staff experienced the opposite.

    Purpose

    The QI-project aimed to improve the availability to the courses by making the e-catalogue more accessible and user-friendly.

    This study aimed to describe the staff's perception of the factors affecting the functioning of the e-catalogue at a micro, meso and macro level. The study was delimited to include the business perspective.

    Method

    The improvement ramp and the model of improvement. Focus interviews was analyzed with qualitative content analysis and linked to micro, meso and macro level with The Clinical Adoption Framework (CAF) as a theoretical reference frame.

    Results

    The QI-project didn't meet its objectives in full. The content analysis identified six factors at micro and meso level.

    Conclusions 

    For a digital tool to be perceived as useful, knowledge about the organization and its processes at a micro level is required, so that the right conditions and support can be given at a meso level.

  • 213.
    Wranne, Birgitta
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Förbättringsarbete om att öka patientens delaktighet: En fallstudie om att införa personcentrerad vård på en kardiologisk vårdenhet2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Enligt nationella patientenkäten är patienterna nöjda med vården, däremot skattas inte delaktigheten lika högt.  Ett sätt att öka delaktigheten är personcentrerad vård, som dessutom kan ge en mer effektiv vård med högre kvalitet. 

    Syfte: Studiens syfte var att beskriva och analysera ett förbättringsarbete om att öka patientens delaktighet genom införande av personcentrerad vård på en kardiologisk vårdenhet.

    Metod: Förbättringsarbetet genomfördes enligt Nolans förbättringsmodell. Studien var en fallstudie med induktiv ansats. Kvantitativ datainsamling skedde genom enkäter till patienter och medarbetare före och efter fem månaders förbättringsarbete. Kvalitativ datainsamling skedde genom foksugruppsintervjuer med medarbetare.

    Resultat: Enkäterna visade inga tydliga skillnader efter fem månaders förbättringsarbete. Både patienter och medarbetare skattade patientdelaktigheten högt. Det som skattades lägst av båda grupper var hänsynstagande till arbete, levnadsvanor och tidigare erfarenhet av sjukhusvård.

    Fokusgruppsintervjuerna visade att välinformerade patienter i större utsträckning kunde vara mer delaktiga. Medarbetarna fick en bättre förståelse av patienten, samtidigt fanns oro över att missa viktig information. Viljan fanns till personcentrering, men förutsättningarna saknades.

    Slutsats: Förbättringsmodellen är lämplig för införande av personcentrerad vård för att kunna testa vad som fungerar praktiskt. För att lyckas behövs tid och stöd från ledningen. Medarbetarna behöver träning, coaching och få vara delaktiga i förbättringsarbetet.

  • 214.
    Wright, Rebecca J.
    et al.
    Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK.
    Lowton, Karen
    Department of Sociology, University of Sussex, Brighton, UK.
    Robert, Glenn
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK.
    Grudzen, Corita R
    Ronald O. Perelman Department of Emergency Medicine, School of Medicine, New York University, New York, NY, USA.
    Grocott, Patricia
    Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK.
    Emergency department staff priorities for improving palliative care provision for older people: A qualitative study2018In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 32, no 2, p. 417-425Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Emergency department-based palliative care services are increasing, but research to develop these services rarely includes input from emergency clinicians, jeopardizing the effectiveness of subsequent palliative care interventions.

    AIM: To collaboratively identify with emergency clinicians' improvement priorities for emergency department-based palliative care for older people.

    DESIGN: This was one component of an experience-based co-design project, conducted using semi-structured interviews and feedback sessions.

    SETTING/PARTICIPANTS: In-depth interviews with 15 emergency clinicians (nurses and doctors) at a large teaching hospital emergency department in the United Kingdom exploring experiences of palliative care delivery for older people. A thematic analysis identified core challenges that were presented to 64 clinicians over five feedback sessions, validating interview findings, and identifying shared priorities for improving palliative care delivery.

    RESULTS: Eight challenges emerged: patient age; access to information; communication with patients, family members, and clinicians; understanding of palliative care; role uncertainty; complex systems and processes; time constraints; and limited training and education. Through feedback sessions, clinicians selected four challenges as improvement priorities: time constraints; communication and information; systems and processes; and understanding of palliative care. As resulting improvement plans evolved, "training and education" replaced "time constraints" as a priority.

    CONCLUSION: Clinician priorities for improving emergency department-based palliative care were identified through collaborative, iterative processes. Though generally aware of older palliative patients' needs, clinicians struggled to provide high-quality care due to a range of complex factors. Further research should identify whether priorities are shared across other emergency departments, and develop, implement, and evaluate strategies developed by clinicians.

  • 215.
    Ödman, Linda
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ge barnen tid!: En studie av ett förbättringsarbete för ökad tillgänglighet till barnpsykiatriska utredningar genom samordnat processflöde.2016Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [sv]

    Reducerad väntetid till barnpsykiatrisk vård är ett prioriterat område då försenad vård har negativ inverkan på barns liv och hälsa.

    Syftet med förbättringsarbetet: Ökad tillgänglighet till barnpsykiatrisk utredning samt sammanhållen utredningstid med stöd av förbättringsmetoder.

    Syftet med studien: Beskriva användarnas, utredningsteamets, upplevelser av införandet av samordnat tvärprofessionellt processflöde för barnpsykiatrisk utredning.

    Förbättringsarbetet genomfördes med stöd av förbättringsmetoder. Förbättringsidén utgörs av ett tvärprofessionellt samordnat processflöde, där barnpsykiatrisk utredning skall vara planerad, genomförd och återlämnad inom fem veckor.

    Studiens metod: Kvalitativ och utgörs av fokusgruppsinterjuver.

    Resultat: Samordnat processflöde medförde att 93 % av patienterna utreddes inom regionala riktlinjers rekommenderade 120 dagar. Väntetiden reducerades från 9 till 4 månader efter utgången vårdgaranti. Utredningslängd minskade från bakgrundsmätnings 236 dagar till 48 dagar. Studien visar att samordnat utredningsschema kräver tvärprofessionell samordning, delaktiga medarbetare, lärande organisation, styrande, stödjande och delegerat ledarskap samt att omkringliggande system är effektiva. Systemet är sårbart och arbetsmiljön belastas.

     

    Slutsats: Samordnat tvärprofessionellt processflöde ökade tillgänglighet till barnpsykiatriska utredningar samt sammanhållen utredningstid. Tvärprofessionell samordning, implementering av förbättringskunskap, lärande organisation, involverade och delaktiga medarbetare, effektiv organisation samt ett styrande, stödjande och delegerat ledarskap är avgörande faktorer för processens görlighet. Processflödet var sårbart för yttre faktorer. Upplevelsen var att arbetsmiljön belastas.

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