Endre søk
Begrens søket
1234567 51 - 100 of 533
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 51.
    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).
    Utforska och kontrollera för innovation i vardagen – två praktiska exempel [video]2020Annet (Annet (populærvitenskap, debatt, mm))
  • 52.
    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).
    Öka innovationskraften i vardagens processer [video]2020Annet (Annet (populærvitenskap, debatt, mm))
  • 53.
    Avby, Gunilla
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of 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). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Andersson Bäck, Monica
    University of Gothenburg.
    A reform as a lever for innovation and professionalism?2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: Consistently with international trends, managerial reforms and incentive systems in Sweden have been introduced to achieve quality improvement and increased efficiency in welfare services. Evidence suggests that targeted financial micro-incentives can stimulate change in certain areas of care, but they do not result in more radical change, such as service transformations or innovation.

    Aim: In this study we explore how organizational performance are changing within the context of a patient choice reform in primary healthcare.

    Material and Methods: This qualitative study is based on 48 semi-structured interviews with various professions (managers, physicians, nurses, physical- and occupational therapists, care administrators, and nurse assistants) at five PHCCs, conducted as part of a study designed to explore financial incentives and motivation in PHC in Sweden. The PHCCs were purposively selected to ensure the inclusion of both public and private facilities. All centers had a longstanding reputation for good leadership and high quality care. 

    Results: The findings show how professional fields and traits were dissolving and changing, triggering the emergence of innovative solutions in practice. Through ongoing negotiations of professional boundaries new practices unfolded and professionalism increasingly was achieved through contextual conditions. The expanding and changing of professional boundaries as shown in the study are implied to stimulate innovative processes. Thus, the main findings suggest that innovative practices developed as a relationship between contextual conditions and professionalism. E.g. nurses and physical therapists remitted patients directly to the hospital, multiprofessional teams for patient groups with joint needs handled patients that previous needed hospital care, and nurse assistants became responsible for summing patients with minor hypertension for blood pressure controls and consultations.

    Conclusions: The reform seemed to act as a lever for innovation and professionalism under certain conditions. How work is organized and managed is a contextual factor that not only affects work circumstances, but also provides conditions for innovation and professionalism. Impartial to governments’ ambitions to improve their responsiveness to the needs of citizens by altering market rules, new provider models may be of little assistance in achieving the desired effect on health sector reform outcomes if suitable contextual conditions are missing.

  • 54.
    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).
    Andersson Bäck, Monica
    Department of Social Work, University of Gothenburg, Göteborg, Sweden.
    Tending to innovate in Swedish primary health care: a qualitative study2019Inngår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, nr 1, artikkel-id 42Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

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

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

  • 55.
    Avby, Gunilla
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of 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). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Andersson Bäck, Monica
    University of Gothenburg.
    Transforming primary healthcare: Exploring a new provider model as a lever for innovation and professionalism2017Konferansepaper (Fagfellevurdert)
  • 56.
    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).
    Andersson Bäck, Monica
    Göteborgs universitet.
    Areskoug Josefsson, Kristina
    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). Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Sparf, Anette
    Siljehult, Mats
    Samarbete bygger en stark primärvård2017Inngår i: Dagens Nyheter 2017-08-17, ISSN 1101-2447Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 57.
    Azdajic, Tomislav
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Förbättrat deltagande i träningsbaserad hjärtrehabilitering med hjälp av beteendeförändringstekniker: En kvalitativ studie baserad på beteendeförändringsmodellen COM-B2021Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Bakgrund: Under de senaste 30 åren har dödligheten i hjärt-kärlsjukdomarna minskat och fler och fler personer lever med sjukdomen. Träningsbaserad hjärtrehabilitering (THR) är en effektiv sekundär-preventiv åtgärd som förblir en underutnyttjad behandlingsform på grund av bristfälligt deltagande.

    Syfte: Syftet med förbättringsarbetet var att förbättra deltagande i THR. Syftet med studien av förbätt-ringsarbetet var att genom den teoretiska modellen COM-B undersöka hur patienter uppfattar vad som underlättar eller hindrar deras deltagande i THR.

    Metod: Med hjälp av Nolans förbättringsmodell testades två förändringar inom ramen för THR, näm-ligen ”Min träningsplan” och ”Träning ute”. Studie av förbättringsarbetet var en kvalitativ studie som baserades på COM-B modellen. Data från sju semistrukturerade intervjuer transkriberades och analy-serades med hjälp av deduktiv innehållsanalys.

    Resultat: Resultat av förbättringsarbetet visade förbättrat deltagande i THR. I genomsnitt påbörjade 62 % av patienterna THR och de deltog i genomsnitt två tillfällen mer än före förbättringsarbetet. Stu-dien av förbättringsarbetet visade på att dynamiskt tankesätt, aktiv livsstil, stöttning, ansvarstagande, målbilder, positiva känslor kring träning och upplägg verkade vara förknippade med det som underlät-tade deltagande i THR. Det som hindrade deltagande i THR var samsjuklighet och trötthet, svårighet att få ihop sitt livspussel samt oro och rädsla kring fysisk aktivitet.

    Slutsats: Oberoende vilka förändringsidéer som hade testats framstod det att patienternas egna för-mågor och motivation utvecklades genom större fokus på beteendeförändring som framtagande av ”Min träningsplan” och ”Träning ute” gav upphov till. Det sociala sammanhanget, trygghet kring fysisk akti-vitet, framtidshopp, välbefinnande och längtan till livet innan sjukdomen var faktorer som gjorde att deltagande i THR ersatte andra konkurrerande beteenden.

    Fulltekst (pdf)
    Fulltext
  • 58.
    Azong, Jecynta Amboh
    et al.
    University of Stirling, UK.
    Wilinska, Monika
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). University of Stirling, UK.
    Into a footnote: Unpaid care work and the Equality Budget in Scotland2017Inngår i: The European Journal of Women's Studies, ISSN 1350-5068, E-ISSN 1461-7420, Vol. 24, nr 3, s. 218-232Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article analyses the visibility of unpaid care work in Scotland by examining the (non-)development of discourse on unpaid care work in economic policy documents. Drawing on the problem approach to policy analysis, the article engages with the Equality Budget Statements (EBS) as policy documents that not only inform the government’s spending plans but are foremost statements of values and norms pursued by the government. This critical reading reveals that certain discourses give different meanings to women’s lives through the political significance of what remains unproblematized as part of the ensuing care discourse in Scotland. The developing discourse on economic policy and equality suggests that equality in Scotland is presupposed on labour market participation. This shrinks discourse on unpaid care work; the problem of unpaid care work is silenced, while the problem of women’s access to employment is redefined to mean a problem of difference and costly childcare only. The way certain issues have or have not appeared in governmental documents is explanatory of the importance and relevance of unpaid care work to the political discourse.

  • 59.
    Badu Massaque, Faith
    Jönköping University, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd. Jönköping Academy.
    Förbättrade grundförutsättningar för teamarbete.: -en intervjustudie av ett förbättringsarbete om teamsamverkan inom specialiserad barnsjukvård2021Independent thesis Advanced level (degree of Master (Two Years)), 20 hpOppgave
    Abstract [sv]

    Effektiv kommunikation mellan vårdens medarbetare är väsentlig för patientsäker vård. Bristfällig kommunikation är kopplad till vårdskador. På den slutenvårdsavdelning i södra Sverige, där både aktuellt förbättringsarbete och studie genomfördes, saknades ett strukturerat arbetssätt för utbyte av viktig information kring barn och ungdomars vård inom ett team av nattarbetare. Därför startades ett förbättringsarbete vilket sedan undersöktes genom en intervjustudie.

    Genom att införa samling av berörda medarbetare vid varje ny patientinläggning, och tidsbestämda avstämningar som gjordes med ett kommunikationsverktyg, TEAMUP-modellen (T-trust, E-explore, A-ambition, M-model, U-undertake, P-praise) syftade förbättringsarbetet till at etablera en arbetsstruktur som möjliggör effektiv kommunikation i teamet för att minska förekomst av vårdskador samt förbättra arbetsklimatet. Förbättringsarbetet genomfördes med stöd av Nolans modell tillsammans med PDSA- cyklar (P-Plan, D-Do, S-Study, A-Act), fiskbendiagram, förbättringsramen samt värdekompass. I förbättringsarbetet deltog cirka arton nattpersonal och tio vårdnadshavare/barn >15 år. Data samlades in genom enkäter och visualiserades med figurer. Enkätsvaren visade att de nya arbetssätten har möjliggjort strukturerad kommunikation för inforamtionsbyte i teamet kring barn och ungdomars vård och behandlingar. Bland vårdnadshavare/ barn >15 år visade enkätsvaren 100% nöjdhet beträffande kommunikation i teamet kring patienters vård och behandlingar. Av personalen angav 87% att arbetsklimatet förbättrades till föjld av de nya arbetssätten. 

    En kvalitativ intervjustudie gjordes när förbättringsarbetet avslutades med syfte till att undersöka hur personalen uppfattar att TEAMUP -modellen och samling vid patientinläggning har påverkat deras interna samarbete med avseende på kommunikation i teamet. En semistrukturerad intervjuguide anvvändes. Åtta medarbetare i nattpersonalgruppen medverkade i intervjuer. Data analyserades genom kvalitativ innehållsanalys. De intervjude medarbetarna beskrev att kommunikation och samarbete i teamet förbättrades. Med hjälp av de nya arbetssätten kunde personalen skapa en kultur som innebar att hjälpa varandra mer då de informerade varandra om viktiga förhållanden gällande patienter, avdelningsresurser, diagnoser och missnöje. 

    Fulltekst (pdf)
    fulltext
  • 60.
    Bartholdson, Pamela
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Så förhindrar vi fallolyckor - Observationsstudie av en multifaktoriell intervention2013Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Fulltekst (pdf)
    Masteruppsats_Pamela_Bartholdson
  • 61.
    Batalden, Maren
    et al.
    Department of Medicine, Cambridge Health Alliance, Cambridge, MA, United States.
    Batalden, Paul B.
    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). Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth, Lebanon, NH, United States.
    Margolis, Peter
    Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
    Seid, Michael
    Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
    Armstrong, Gail
    College of Nursing, University of Colorado, Aurora, CO, United States.
    Opipari-Arrigan, Lisa
    Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
    Hartung, Hans
    Department of Pulmonary Medicine, University Hospital Crosshouse, Kilmarnock, East Ayrshire, United Kingdom.
    Coproduction of healthcare service2016Inngår i: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 25, nr 7, s. 509-517Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Efforts to ensure effective participation of patients in healthcare are called by many names - patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services.

    Fulltekst (pdf)
    Fulltext
  • 62.
    Batalden, Paul B.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Dartmouth Institute for Health Policy and Clinical Practice, Geisel Medical School, Dartmouth College, Lebanon, NH, United States.
    Getting more health from healthcare: Quality improvement must acknowledge patient coproduction - An essay by Paul Batalden2018Inngår i: BMJ. British Medical Journal, ISSN 0959-8146, E-ISSN 0959-535X, Vol. 362, artikkel-id k3617Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Modelling healthcare as either a product or a service neglects essential aspects of coproduction between doctors and patients. Paul Batalden shares his learning from 10 years of studying change.

  • 63.
    Batalden, Paul B.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Intermission: A coproduction fika [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    In the Swedish practice of “fika” workers gather for coffee and a small sandwich in mid-morning. They then talk about their work. In this episode, we use the idea of “fika” to reflect on what we’ve learned about coproduction so far and where we’re headed next: how science informs the practices where “disease or condition”, “illness”, and “service” come together. Knowledge of all three components is basic to the coproduction of a healthcare service. Integrating them is a form of knowledge and skill in itself.

  • 64.
    Batalden, Paul B.
    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). Geisel Medical School at Dartmouth.
    Introduction: Paul on coproduction [podcast]2021Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Distilling many years of experience examining the different applications of the coproduction of healthcare service in diverse settings, Paul Batalden describes a way of understanding its key components. He shares some of the knowledge, skills and habits that contribute to coproducing a healthcare service along with the implications and benefits of new framing to improve health care overall.

  • 65.
    Batalden, Paul B.
    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). Geisel Medical School at Dartmouth.
    Arvidsson, Charlotte
    Family physician and medical educator for Region Jönköping, Sweden.
    Chao, Serena
    Chief of Geriatrics Division,Cambridge Health Alliance (CHA), Director of CHA’s House Calls Program, Co-Chair of CHA’s Post-Acute Committee and Instructor of Medicine,Harvard Medical School.
    Episode 2: The person will see you now [podcast]2021Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Lotta Arvidsson worked with a learning partner to gain insight into the lived reality of someone struggling with congestive heart failure. She was subsequently able to apply some of those approaches to her practice as a primary care physician.

    Serena Chao found a way to visualize the setting in which her patient’s family was making decisions that relied heavily on the emergency care system. This enabled Serena to identify and implement changes in her geriatric practice to lessen the family’s reliance on emergency care.

    Paul focuses his takeaways on how to build on the knowledge that Lotta and Serena gained.

  • 66.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Batalden, Sonja
    Nurse-Midwife & Director of Perinatal Care, Minnesota Community Care (MCC), St. Paul, Minnesota, USA.
    Banigo, Diane
    Social Architect and Nurse-Midwife Health Consultant.
    Episode 5: Stop talking! Equity begins by listening [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Sonja and Diane knew that as an organization they could do better with their services for African-American women during pregnancy. The two nurse leaders, who’d also served as nurse midwives, began a program of active listening to improve their understanding of pregnant womens’ stories, observations, questions, frustrations...and so much more. As Sonja and Diane built “DIVA Moms” they worked to connect what they heard with what they and their colleagues did. Together, they built a different way.

    Sonja and Diane tell Paul how they co-created DIVA Moms.

  • 67.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Brennan, John
    MD, General Practitioner, Ballyhale Health Centre, Co. Kilkenny, Ireland.
    Episode 10: My work depends on the setting ... [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    John tells us how his work environments influence the content of his work. In his experiences with two settings, he illustrates concretely how this happens and what difference it makes to him as a physician-person.

  • 68.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Johnson, Julie
    Department of Surgery and the Center for Health Services Outcomes Research, Northwestern University, Evanston, Illinois, USA.
    Bryant, Chandlee
    Career Advisor to Undergraduates, Dartmouth College, Hanover, New Hampshire, USA.
    Episode 3: Let's get real: the way things are [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    When healthcare “professionals'' listen to the steps people must take to get healthcare services, and what those experiences are actually like, understanding begins. As these stories unfold there’s opportunity for gaining even greater insight into the surprises and the feelings associated with the “patient” journey.

    This is what happened for Julie and Chandlee as each took in what patients had to navigate to get necessary care and support. It was eye opening to say the least, and helped everyone see that the current state of much of healthcare service, this “as is” system, is where the worlds of the “patient-person” and the “professional-person” meet. And, often unhappily. But, this first step is crucial for determining what needs changing. Paul extrapolates from Julie’s and Chandlee’s stories to describe the tools and methods that are helpful to regularly discovering and documenting the current state of the system.

  • 69.
    Batalden, Paul B.
    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). Geisel Medical School at Dartmouth.
    Jones, Fiona
    Rehabilitation Research, St George’s University, London, UK; Kingston University, Kingston upon Thames, UK; Founder and CEO, Bridges Self-Management Limited, London, UK.
    Episode 4: Allow me to empower you: the wisdom of self-care [podcast]2021Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    What started as an intervention has become a way of being for Fiona Jones and her colleagues. Fiona started with her clinical training as a physical therapist, which meant doing things “to” patient-persons. When she moved from hospital settings to home settings, she began to appreciate the variety of PT practices people had come up with on their own. She began to wonder, “what if we combined forces?”

    Fiona shares her insights with Paul into the language and practices that help people navigate the continuum of support for self-care.

  • 70.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Kirkland, Kathryn
    MD, Dorothy and John J. Byrne, Jr. Distinguished Professor and Chief of Palliative Medicine, Geisel School of Medicine and Dartmouth-Hitchcock Health.
    Episode 9: Stories clarify [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Kathy’s story starts with the lived reality and prognosis for a patient-person in a coma on a ventilator machine. She invited everyone involved to describe the situation. Their narratives revealed that family members and the neurologist had very different understandings of the word “okay.” Kathy connected these insights with scientific data to enable the interested parties to come to a common understanding and decide next steps. Kathy draws on this experience when she teaches others the value of narrative medicine. Among other things, it’s a way to clarify what’s at stake and to correct misunderstandings, especially when critical medical decisions must be made.

  • 71.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Kyle, April
    President and CEO for Southcentral Foundation's Nuka System of Care, Anchorage, AK, USA.
    Episode 12: Coproduction and macrosystems of healthcare [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    April and Doug bring their long familiarity to describe the transformative change when the indigenous community became the “customer-owners,” as they now call the members of the Native American community. They explore the way commonly occurring meetings happen and some of the implications for their work as executive-persons in the setting. April describes what it’s like getting a professional-person’s help for a problem. Doug describes some of the data that is used to measure the changes that have occurred since the change.

  • 72.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy & Clinical Practice, Hanover, NH, USA.
    Lachman, Peter
    Department of Quality Improvement, Royal College of Physicians of Ireland, Dublin, Ireland.
    von Plessen, Christian
    Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland; Direction Générale de la Santé, Lausanne, Switzerland.
    Johnson, Julie K.
    Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES), Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
    García-Elorrio, Ezequiel
    Instituto de Efectividad Clínica y Sanitaria, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
    Coproduction of healthcare services: from concept to implementation2023Inngår i: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 35, nr 4, artikkel-id mzad083Artikkel i tidsskrift (Annet vitenskapelig)
  • 73.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Lind, Cristin
    Project Manager, European Patients’ Academy on Therapeutic Innovation (EUPATI) Sweden, Swedish Disability Rights Federation and Facilitator-in-Preparation, Center for Courage and Renewal.
    Episode 7: The web I tend [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Living with a long term condition that begins at birth involves so many unplanned needs. It invites a diverse set of resources to help. Putting them all together to support the flourishing of a person involves building and integrating new knowledge. If a condition is present from birth, everything changes as the child grows and develops. Cristin’s experience helping her son, Gabriel, invites us to understand the journey.

  • 74.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Lucas, Bill
    Professor of Learning and Director of the Centre for Real World Learning, Winchester University, UK.
    Episode 11: From principles to practices [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    After describing a situation where learning and the “learner” seem “blocked”, Bill explores the creative ways teachers address situations like this. Together, Bill and Paul discuss the multiple issues that arise when learning new/different knowledge, skills and dispositions (habits) and using them in daily work. Their conversation explores traps that commonly occur and an overview of ways to start.

  • 75.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Marshall, Bruce
    Chief Medical Officer and Executive Vice President, Cystic Fibrosis (CF) Foundation.
    Episode 6: The biology of it all [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Bruce Marshall describes the journey of developing biologic knowledge of Cystic Fibrosis (CF), an inherited condition. He illustrates the variety of methods that contributed to this development and suggests how CF knowledge impacts the design of coproduced services and the lives of those with Cystic Fibrosis.

  • 76.
    Batalden, Paul B.
    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). The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
    Ovalle, Anais
    Leadership Preventive Medicine Residency Program, Section of Infectious Disease, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
    Foster, Tina
    The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA;Departments of Obstetrics and Gynecology and Community & Family Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Hanover and Lebanon, NH, USA.
    Elwyn, Glyn
    The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
    Science-informed practice: an essential epistemologic contributor to health-care coproduction2021Inngår i: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 33, nr Supplement 2, s. ii4-ii5Artikkel i tidsskrift (Annet vitenskapelig)
  • 77.
    Batalden, Paul B.
    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). Geisel Medical School at Dartmouth.
    Sabadosa, Kathryn A.
    CF Learning Network; Learning & Leadership Collaborative.
    Leach, David
    Former Executive Director of the Accreditation Council for Graduate Medical Education (ACGME).
    Episode 1: Coproduction is everywhere [podcast]2021Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Paul invites his guests, Kathryn Sabadosa and David Leach, to share a time when healthcare services worked well.

    Kathryn describes the experience of her son, born 20+ years ago with Cystic Fibrosis. She describes the recent changes in the routine care for people with CF and the way together they are changing “good” care for him, and some of the ways that COVID-19 has changed her son’s interactions with professionals.

    David describes his experience deciding to have heart surgery. He focuses on how he sought out the ‘person’ in the professionals he met and worked with.

    After a three-way conversation, Paul offers this episode’s takeaways, focused on the importance of discovering and noticing coproduction in daily healthcare services.

  • 78.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Sodemann, Morten
    University Professor of Global and Migrant Health, University of Southern Denmark. Senior Consultant, The Migrant Health Clinic, Odense University Hospital.
    Episode 8: Am I allowed to cry here? [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Creating a safe healthcare space for immigrants who have many issues going on in their lives all at once, invites attention to many factors. Like any good science, it starts with honest inquiry and good tools–clinical tools. Morten describes how these came together to support the co-creation of services at an immigrant clinic in Odense, Denmark.

  • 79.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    Vincent, Charles
    University of Oxford, UK.
    Batalden, Maren
    Chief Quality Officer at Cambridge Health Alliance, Cambridge, MA, USA.
    Episode 13: Safer together [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    The realization that safer healthcare is not a “binary” phenomenon, but a result from a complex set of factors working together in various ways and that healthcare is not limited to what occurs in hospitals led Charles and his colleague to work together to write their important book. Maren and her colleagues at Cambridge Health Alliance near Boston took those ideas and built their efforts. She describes how direct involvement of a patient and his spouse offered a much more helpful understanding of a fall that occurred shortly after this patient-person was admitted to the hospital. Together they illustrate how ideas become new ways of conducting the daily work of making safer healthcare. They open consideration of how automation enters the co-productive workspace and illustrate both its opportunities and its challenges.

  • 80.
    Batalden, Paul B.
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Geisel Medical School at Dartmouth.
    von Plessen, Christian
    Senior advisor for health care quality and safety to the Health Authority of the Canton of Vaud.
    Foster, Tina
    Dartmouth Health and the Geisel School of Medicine at Dartmouth.
    Episode 14: Looking back and ahead [podcast]2022Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Paul, Christian, and Tina weave the foundational content for coproducing healthcare service and a frame for thinking. They reflect on several possible additional themes for subsequent attention. They discuss some of the personal tips that have been helpful in their own thinking & work to further the work of coproducing healthcare service. They hint at the exciting challenges they see moving forward

  • 81.
    Beckerman, Carina
    Handelshögskolan i Stockholm.
    Historien om en datajournal2005Rapport (Annet vitenskapelig)
    Abstract [sv]

    “Berätta för mig om datajournalprojektet? ”Med den uppmaningen i huvudet gick jag till mitt första möte med fyra anställda på en medicinsk avdelning på X-sjukhuset som ett år tidigare implementerat en datorbaserad patientjournal. Patientjournaler tillhör ju, liksom exempelvis flygledarjournaler, en viss sorts intellektuella artefakter som tills nyligen skrevs för hand med penna på papper. Den kunskap som ligger bakom produktionen av dessa föremål lärs ofta in på plats från en överordnad genom upprepad handling. När arbetsverktyg som dessa datorbaseras sker det inte smärtfritt. Både arbetsrutiner och arbetsrelationer förändras liksom även innehållet i dokumentet. Eftersom jag dessutom ville skaffa erfarenhet av narrativ metod så beslöt jag att låta fyra anställda och projektledaren på kliniken berätta så fritt som möjligt utan inblandning från min sida; därav ovanstående enkla uppmaning. Varför narrativ metod, undrar möjligen en del. Det är inte en vanlig metod inom forskning om informationssystem. Nej, men personligen tror jag och många andra med mig att historier spelar en ofta bortglömd roll i olika organisationers försök att utveckla, implementera och använda informationsteknologi. Detta, och den amerikanske sociologen Elliot Mishlers kritik om att ett alltför strukturerat sätt att intervjua förvandlar människor till artificiella objekt samtidigt som viktiga aspekter i exempelvis förändringsprocesser går förlorade, gjorde mig intresserad av att pröva narrativ metod. Dessutom är patientjournalen i sig en berättelse om en patients sjukdom. Många människor på olika arbetsplatser genomgår numera också dessa så flitigt förekommande IT-projekt, en del lyckade och andra mindre lyckade. En målgrupp för denna studie är därför personer som på olika sätt deltar i och arbetar med implementering av ny informationsteknologi inom sjukvården. En annan målgrupp är kollegor intresserade av narrativ metod.

  • 82.
    Beckerman, Carina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Implications of Transforming the Patient Record into a Knowledge Management System: Initiating a Movement of Coordination and Enhancement2008Inngår i: The ICFAI University Journal of Knowledge Management, ISSN 0972-9216, Vol. Nov, nr 6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Today there is often a need to re-innovate who you are and what you do and re-think the tools that are used and the business models that guide action. The purpose of this paper is to show how transforming a document, such as a patient record, might start a horizontal and vertical movement, a movement of coordination and enhancement in an organizational setting, such as a hospital clinic. The observations presented here and the conclusions drawn were obtained during a three year case study following implications of constructing and computerizing a patient record at three different hospitals. The results were then analyzed, interpreted and discussed within a framework combining theories about knowledge management and with cognitive theories about use of interpretative schemes and representations. This paper tries to look beyond the implications of reconstructing a patient record on a micro-level or explore if it is good or bad to computerize it. Instead this paper theorizes about how re-thinking the interpretative scheme for what a patient record is and how it may be used might restructure a health care setting. It proposes that what the employees want to achieve with the knowledge management system depends on what strategy they have for it.

    Fulltekst (pdf)
    FULLTEXT01
  • 83.
    Beckerman, Carina
    Handelshögskolan i Stockholm.
    Sjukhus eller sjukvård - design av betong och infrastruktur2008Inngår i: Detta borde vårddebatten handla om / [ed] Claes-Fredrik Helgesson, Hans Winberg, Stockholm: IFL/EFI , 2008, s. 61-77Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 84.
    Beckerman, Carina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete.
    Transforming and Computerizing Professional Artifacts: An Underestimated Opportunity for Learning2010Inngår i: International Journal of Healthcare Delivery Reform Initiative, ISSN 1938-0216, Vol. 2, nr 3, s. -10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Improving the artifacts a knowledge worker uses and how he or she exercises his or her knowledge is a desire that is part of being professional, especially since modern man are supposed to live in a knowledge society. In the knowledge society there is a continuous structuring and re-structuring, construction and re-construction and learning and re-learning going on due to implementing new information and communication technology. But many of these projects fail in spite of management spending huge amounts of money on them. This paper focuses on and wants to create an awareness of how an artefact such as a new knowledge management system becomes a driving force behind expanding the knowledge of an anesthesist and has implications for continuous learning among a group of employees at the anesthesia and intensive care unit. In addition to this, implementing new technology is an underestimated opportunity for learning. This paper suggests that a significant educational effort is taking place in society channelled through many these IT-projects, even when they fail.

  • 85. Behm, L.
    et al.
    Gustafsson, Susanne
    Göteborgs universitet.
    Hälsofrämjande och sjukdomsförebyggande insatser för de allra äldsta2017Inngår i: Hemsjukvård / [ed] Eva Drevenhorn, Lund: Studentlitteratur AB, 2017, 2, s. 133-148Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 86.
    Bergerum, Carolina
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Akademin för vård, arbetsliv och välfärd, Institutionen för arbetsliv och välfärd, Högskolan i Borås.
    Patient and public involvement in hospital quality improvement interventions: the mechanisms, monitoring and management2022Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    This dissertation focuses on the mechanisms, monitoring and management of patient and public involvement in hospital quality improvement (QI) interventions. Findings from a literature review generated an initial programme theory (PT) on active patient involvement in healthcare QI interventions (Paper 1). Empirical studies were also undertaken in order to describe what was actually happening in the hospital QI teams and what patients and professionals experience influence their joint involvement (Paper 2), and to compare hospital leaders’ and managers’ experiences of managing QI interventions involving patients and the public (Paper 3). Finally, it was studied how patient-reported measures stimulate patient involvement in QI interventions in practice (Paper 4).

    The research had a qualitative design. The approach was descriptive and comparative, and the studies were carried out prospectively. Data were collected in two hospital organisations in Sweden and in one hospital organisation in the Netherlands. Data collection methods were a literature search (Paper 1), interviews and field observations (Paper 2 and 3) and data collection meetings (Paper 4). Altogether, 93 team meetings and meetings between the team leaders and management were attended and a total of 20 days of study visits with different forms of meetings were made. Twelve patients, 12 healthcare professionals and 17 and 8 hospital leaders and managers, respectively, participated in the interviews and data collection meetings.

    Realist synthesis was used to formulate the initial PT (Paper 1). Constructivist grounded theory was used to analyse and describe what was happening in the QI teams and how it was experienced by the team members (Paper 2). To compare hospital leaders’ and managers’ different, contextual meanings in Sweden and the Netherlands, the reflexive thematic analysis informed by critical realism was used (Paper 3). To order, manage and map data from 31 examples of local QI interventions associated to patient-reported measures, the framework method was used (Paper 4).

    The results formulate a generic PT on the mechanisms, monitoring and management perspectives of co-produced QI interventions in hospital services where patients and the public are involved. The PT provides a hypothesis on the various mechanisms at play and outcomes obtained at the different levels of hospital organisations in the process. It is argued that focus should be on experiences, interaction, relationships and dialogue, integration of context, and the matching of hospital resources to patient and public demands and needs. Subsequently, the outcome will be the resources and reasoning interplay resulting in actions and processes, experiences and knowledge, ‘product’ benefits, emotions, judgements and motivations. Monitoring constitutes an important feedback loop to enable such learnings. The PT aligns the perspectives of the clinical microsystem, improvement science and the service-dominant logic, and has a potential to explain how patient and public involvement in QI interventions might work.

    Fulltekst (pdf)
    Kappa
    Download (png)
    Cover
  • 87.
    Bergerum, Carolina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Quality Improvement in a Maternity Ward and Neonatal Intensive Care Unit. What are staff and patients' experiences of Experience-based Co-design?: Part 1: A qualitative study2012Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Background: Recent focus on quality and patient safety has underlined the need to involve patients in improving healthcare. “Experience-based Co-design” (EBCD) is an approach to capture and understand patient and staff (i. e. users) experiences, identifying so called “touch points” and then working together equally in improvement efforts.

    Purpose:This article elucidates patient (defined as the mother-newborn couple with next of kin) and staff experiences following improvement work carried out according to EBCD in a maternity ward and neonatal intensive care unit (NICU) in a small, acute hospital in Sweden.

    Method: An experience questionnaire, derived from the EBCD approach tool set, was used for continuously evaluating each event of the EBCD improvement project. Furthermore, a focus group interview with staff and in-depth interviews with mother-father couples were held in order to collect and understand the experiences of working together according to EBCD. The analysis and interpretation of the interview data was carried through using qualitative, problem-driven content analysis. Themes, categories and sub-categories presented in this study constitute the manifest and latent content of the participants’ experiences of Experience-based Co-design.

    Results:The analysis of the experience questionnaires, prior to the interviews, revealed mostly positive experiences of the participation. Both staff and patient participants stated generally happy, involved, safe, good and comfortable experiences following each event of the improvement project so far.

    Two themes emerged during the analysis of the interviews. For staff participants the improvement project was a matter of learning within the microsystem through managing practical issues, moving beyond assumptions of improvement work and gaining a new way of thinking. For patients, taking part of the improvement project was expressed as the experience of involvement in healthcare through their participation and through a sense of improving for the future.

    Discussion: This study confirms that, despite practical obstacles for participants, the EBCD approach to improvement work provided an opportunity for maternity ward /NICU care being explored respectfully at the experience level, by assuring the sincere sharing of useful information within the microsystem continuously, and by encouraging and supporting the equal involvement of both staff and patients. Staff and patients wanted and were able to contribute to the EBCD process of gathering information about their experiences, analyzing and responding to collected data, and engaging themselves in improving the same. Furthermore, the EBCD approach provided staff and patients the opportunity of learning within the microsystem. Nevertheless, the responsibility of the improvement work remained the responsibility of the healthcare professionals.

    Fulltekst (pdf)
    fulltext
  • 88.
    Bergerum, Carolina
    et al.
    Jönköping University, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Engström, A. K.
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, S-501 90, Sweden.
    Thor, Johan
    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).
    Wolmesjö, M.
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, S-501 90, Sweden.
    Patient involvement in quality improvement: a ‘tug of war’ or a dialogue in a learning process to improve healthcare?2020Inngår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, nr 1, artikkel-id 1115Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Co-production and co-design approaches to quality improvement (QI) efforts are gaining momentum in healthcare. Yet, these approaches can be challenging, not least when it comes to patient involvement. The aim of this study was to examine what might influence QI efforts in which patients are involved, as experienced by the patients and the healthcare professionals involved. Methods: This study involved a qualitative design inspired by the constructivist grounded theory. In one mid-sized Swedish hospital’s patient process organisation, data was collected from six QI teams that involved patients in their QI efforts, addressing care paths for patients with transient, chronic and/or multiple parallel diagnoses. Field notes were collected from participant observations during 53 QI team meetings in three of the six patient processes. Individual, semi-structured interviews were conducted with 12 patients and 12 healthcare professionals in all the six QI teams. Results: Patients were involved in QI efforts in different ways. In three of the QI teams, patient representatives attended team meetings regularly. One team consulted patient representatives on a single occasion, one team collected patient preferences structurally from individual interviews with patients, and one team combined interviews and a workshop with patients. The patients’ and healthcare professionals’ expressions of what might influence the QI efforts involving patients were similar in several ways. QI team members emphasized the importance of organisational structure and culture. Furthermore, they expressed a desire for ongoing interaction between patients and healthcare professionals in healthcare QI. Conclusions: QI team members recognised continuous dialogue and collective thinking by the sharing of experiences and preferences between patients and healthcare professionals as essential for achieving better matches between healthcare resources and patient needs in their QI efforts. Significant structural and cultural aspects of performing QI in complex hospital organisations were considered to be obstructions to progress. Therefore, to sustain learning and behaviour change through QI efforts at the team level, a deeper understanding of how structural and cultural aspects of QI promote or prevent success appears essential.

  • 89.
    Bergerum, Carolina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    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).
    Josefsson, Karin
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Wolmesjö, Maria
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    How might patient involvement in healthcare quality improvement efforts work—A realist literature review2019Inngår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 22, nr 5, s. 952-964Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Introduction

    This realist literature review, regarding active patient involvement in healthcare quality improvement (QI), seeks to identify possible mechanisms that contribute to success or failure. Furthermore, the paper outlines key considerations for organizing and supporting patient involvement in healthcare QI efforts.

    Methods

    Two literature searches were performed. Altogether, 1204 articles from a healthcare context were screened, focusing on improvement efforts that involve patients, healthcare professionals and/or managers and leaders. Among these, 107 articles fulfilled the chosen study selection criteria and were further analysed. Eighteen articles underwent a full realist review. In the realist synthesis, context-mechanism-outcome configurations were articulated as middle-range theories and organized thematically to generate a program theory on how active patient involvement in QI efforts might work.

    Results

    The articles exhibited a diversity of patient involvement approaches at different levels of healthcare organizations. To be successful, organizations? support of QI efforts that actively involved patients tailored the QI efforts to their context to achieve the desired outcomes, and involved the relevant microsystem members. Furthermore, it promoted interaction and partnership within the microsystem, and supported the behavioural change that follows.

    Conclusion

    This realist synthesis generates a program theory for active patient involvement in QI efforts; active patient involvement can be a tool (resource), if tailored for interaction and partnership (reasoning), that leads to behaviour change (outcome) within healthcare QI efforts. The theory explains essential resource and reasoning mechanisms, and outcomes that together form guidance for healthcare organizations when managing active patient involvement in QI efforts.

  • 90.
    Bergerum, Carolina
    et al.
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Wolmesjö, Maria
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Thor, Johan
    Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Organising and managing patient and public involvement to enhance quality improvement – Comparing a Swedish and a Dutch hospital2022Inngår i: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 126, nr 7, s. 603-612Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    As co-production approaches to quality improvement (QI) gain importance in healthcare, hospital leaders and managers are expected to organise and support such efforts. Yet, patient and public involvement (PPI) can be challenging. Hospital organisations, emphasising knowledge and evidence domains, are characterised by operational-professional rather than patient-preference led management. Thus, PPI adds aspects of influence and responsibility that are not clearly defined or understood, with limited knowledge about how it can be orchestrated. This study, therefore, aimed to explore hospital leaders' and managers' contextualised experiences of managing QI efforts involving patients, by comparing two European hospitals. The study draws on field observations and qualitative interviews with a total of 21 QI team leaders and hospital managers in a Swedish and a Dutch hospital organisation. The data were subjected to thematic analysis with a critical realist approach. Results define seven themes, or areas, in which mechanisms are at play: (1) patient involvement in hospital QI, and (2) improving outcomes for patients, originating from the strategic view of achieving the hospital vision. Furthermore, (3) societal influence, (4) knowledge and evidence, (5) complexity, (6) individual resources, and (7) cooperation are areas in which mechanisms operate in the process. These areas are equally relevant for both hospitals, yet the mechanisms involved play out differently depending on contextual structure and local means of action.

  • 91.
    Biguet, Gabriele
    et al.
    Karolinska Institutet.
    Ekstrand Sporre, Åsa
    Jönköpings läns landsting.
    Thörne, Karin
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Att utvecklas genom att reflektera tillsammans i grupp2015Inngår i: Att lära och utvecklas i sin profession / [ed] Gabriele Biguet, Ingrid Lindquist, Cathrin Martin, Anna Pettersson, Lund: Studentlitteratur AB, 2015, s. 123-146Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 92. Blackwell, R. W. N.
    et al.
    Lowton, K.
    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). Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, United Kingdom.
    Grudzen, C.
    Grocott, P.
    Using Experience-based Co-design with older patients, their families and staff to improve palliative care experiences in the Emergency Department: A reflective critique on the process and outcomes2017Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 68, s. 83-94Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Increasing use of emergency departments among older patients with palliative needs has led to the development of several service-level interventions intended to improve care quality. There is little evidence of patient and family involvement in developmental processes, and little is known about the experiences of − and preferences for – palliative care delivery in this setting. Participatory action research seeking to enable collaborative working between patients and staff should enhance the impact of local quality improvement work but has not been widely implemented in such a complex setting.

    Objectives

    To critique the feasibility of this methodology as a quality improvement intervention in complex healthcare settings, laying a foundation for future work. Setting an Emergency Department in a large teaching hospital in the United Kingdom.

    Methods

    Experience-based Co-design incorporating: 150 h of nonparticipant observation; semi-structured interviews with 15 staff members about their experiences of palliative care delivery; 5 focus groups with 64 staff members to explore challenges in delivering palliative care; 10 filmed semi-structured interviews with palliative care patients or their family members; a co-design event involving staff, patients and family members.

    Findings

    The study successfully identified quality improvement priorities leading to changes in Emergency Department-palliative care processes. Further outputs were the creation of a patient-family-staff experience training DVD to encourage reflective discussion and the identification and application of generic design principles for improving palliative care in the Emergency Department. There were benefits and challenges associated with using Experience-based Co-design in this setting. Benefits included the flexibility of the approach, the high levels of engagement and responsiveness of patients, families and staff, and the impact of using filmed narrative interviews to enhance the ‘voice’ of seldom heard patients and families. Challenges included high levels of staff turnover during the 19 month project, significant time constraints in the Emergency Department and the ability of older patients and their families to fully participate in the co-design process.

    Conclusion

    Experience-based Co-design is a useful approach for encouraging collaborative working between vulnerable patients, family and staff in complex healthcare environments. The flexibility of the approach allows the specific needs of participants to be accounted for, enabling fuller engagement with those who typically may not be invited to contribute to quality improvement work. Recommendations for future studies in this and similar settings include testing the ‘accelerated' form of the approach and experimenting with alternative ways of increasing involvement of patients/families in the co-design phase. 

  • 93.
    Bonnivier, Anna
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Då; DiabetespatientNu; En människa med diabeteserfarenhet: Ett förbättringsarbete och en fallstudie om vård på ändrade villkor när en diabetesmottagning införde samskapad vård.2018Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Sammanfattning

     

    Bakgrund

    Ett förbättringsutrymme i diabetesvården för personer med förhöjda blodsockernivåer, HbA1c, vilket beskrevs olika utifrån en patient- och medarbetarperspektiv. Förbättringsutrymmet handlade om patientdelaktighet och standardiserade arbetssätt.

    Syfte

    Förbättringsarbete: Att diabetespatienter med förhöjt HbA1c upplevde delaktighet i sin vård och att deras diabetesrelaterade hälsa förbättrades. Mål: sänka medelvärdet för HbA1c> 9%.

    Studie av förbättringsarbete: Studera om och hur införandet av PROM/PREM enkäten bidrog till en samskapad vård utifrån medarbetarnas uppfattning.

    Metod

    Nolans förbättringsmodell

    Fallstudie, kvalitativ innehållsanalys

     

    Resultat:

    Det totala medelvärdet för HbA1c sjönk med 15,2%,

    13 av 14 patienter sänkte sitt HbA1c.

    PROM; två av tre kvalitetsparametrar hade en positiv förskjutning.

    PREM; en av tre kvalitetsparametrar hade en positiv förskjutning.

     

    Resultatet av studien indikerade att medarbetare upplevde en fördjupade vårdrelationen med patienter samt att de uppfattade en balans i kunskapsutbytet mellan deras olika erfarenheter av sjukdomen.

    Diskussion: Resultaten av förbättringsarbete och studie indikerade att samskapad vård skapade förutsättningar till förbättrad diabetesrelaterad hälsa samt upplevd delaktighet. PROM/PREM svaren identifierade områden som möjliggjorde för vårdgivaren att utgå från individens behov vilket stärkte dennes roll i mötet.

    Slutsats: Samskapad vård ger möjligheter till förbättrad diabetesrelaterad hälsa och delaktighet som skapar förutsättningar för kunskapsutbyte och fördjupad vårdrelation mellan patient och vårdgivare.

  • 94.
    Borén, Kristina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Co-production design av ett beslutsstöd för patienter med rotatorkuffruptur2016Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Enligt hälso- och sjukvårdslagen kännetecknas en god vård av att den är individfokuserad, jämlik och säker. Numera finns det en mängd så kallade beslutsstöd som är tillgängliga för patienter inom hälso-och sjukvård i världen. Syftet med dessa är att vara en tillförlitlig källa med hälsoinformation som kan hjälpa patienten att fatta beslut utifrån personliga värderingar. Det saknas dock ett svenskt beslutsstöd som riktar sig till patienter med rotatorkuffruptur. Syftet med denna studie är att vidareutveckla beslutsstödet från USA ”Treatment Options for Rotator Cuff Tears: A Guide for Adults” från 2010 till svenska förhållanden. För att undersöka skillnader och likheter mellan det och svensk behandlingspraxis kring rotatorkuffruptur, samt hur beslutsstödet uppfattas av patienter, så har en co-production design med kvalitativ innehållsanalys med deduktiv ansats använts. Detta innebar översättning av beslutsstödet till svenska, intervjuer med erfarna fysioterapeuter och ortopedläkare som behandlat patienter med rotatorkuffruptur, samt intervjuer med patienter som har haft rotatorkuffruptur och valt behandlingsmetod.

    Studien kom fram till att huvudsakliga likheter mellan beslutsstödet och behandlingspraxis bestod i att patienten har en aktiv roll i behandlingsprocessen, beskrivningen av aktuella behandlingsalternativ och förståelse för skadan. Huvudsakliga skillnader var att läkarens roll var mer framträdande jämfört med fysioterapeutens i beslutsstödet, samt att detaljer kring konservativ och postoperativ behandling saknades. Ortopedläkare och fysioterapeuter beskriver också en avsaknad av ett stödsystem för beslut i dagens kliniska praxis. Patienterna var överlag positiva till beslutsstödet då de upplevde att ett sådant skulle kunna vara ett stöd vid val av behandling, samt att det skulle kunna skapa trygghet. De fann beslutsstödet överlag som enkelt och lättförståeligt med hänsyn till innehåll och layout, samt kunde vara en plattform för dialog med ortopedläkare/fysioterapeut. De sistnämnda var också positiva till beslutsstöd, vilket kan vara en språngbräda för att etablera klinisk konsensus.

    Vidare forskning behövs för att utvärdera effekterna gällande följsamhet till det valda alternativet i beslutsprocessen och vilken detaljnivå som behövs i beslutsstödet. Senaste rön behöver också följas upp för att kunna förbättra innehållet. Det finns också behov av att, med fokus på utfall för patienten, undersöka påverkan på kostnad och effektivitet i vården.

  • 95. Bradbury, Hilary
    et al.
    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).
    Awakening to human centered interaction. Dialogue with Sofia Kjellström [blog post]2019Annet (Annet (populærvitenskap, debatt, mm))
  • 96. Braithwaite, Jeffrey
    et al.
    Hollnagel, Erik
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Hunte, Garth S.
    Discussion, integration and concluding remarks2019Inngår i: Working across boundaries: Resilient health care, volume 5 / [ed] J. Braithwaite, E. Hollnagel & G. S. Hunte, London: CRC Press, 2019, , s. 192s. 165-172Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 97. Braithwaite, Jeffrey
    et al.
    Hollnagel, Erik
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Hunte, Garth S.
    Introduction: The journey to here and what happens next2019Inngår i: Working across boundaries: Resilient health care, volume 5 / [ed] J. Braithwaite, E. Hollnagel & G. S. Hunte, London: CRC Press, 2019, , s. 192s. 3-8Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 98. Braithwaite, Jeffrey
    et al.
    Hollnagel, ErikHögskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.Hunte, Garth S.
    Working across boundaries: Resilient health care, volume 52019Collection/Antologi (Annet vitenskapelig)
  • 99. Braithwaite, Jeffrey
    et al.
    Hollnagel, Erik
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Wears, Robert L.
    Bon voyage: Navigating the boundaries of resilient health care2019Inngår i: Working across boundaries: Resilient health care, volume 5 / [ed] J. Braithwaite, E. Hollnagel & G. S. Hunte, London: CRC Press, 2019, , s. 192s. 9-14Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 100.
    Bremer, Anders
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Kullén Engström, Agneta
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Fredman, Margareta
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Jonasson, Lise-Lotte
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Jutengren, Göran
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Karlsson, Per-Åke
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Sandman, Lars
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Wolmesjö, Maria ()
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Ledarskap i äldreomsorgen: att leda integrerat värdeskapande i en röra av värden och förutsättningar2016Rapport (Fagfellevurdert)
    Abstract [sv]

    Det övergripande syftet med denna rapport är att beskriva chefers etiska värderingar, dilemman och organisatoriska förutsättningar för att bedriva ett värdebaserat ledarskap i såväl kommunal som privat äldreomsorg.

    Det empiriska materialet består av en omfattande enkätstudie till nästan 500 studerande inom ramen för den nationella ledarutbildningen för chefer inom äldreomsorgen vid Högskolan i Borås under perioden 2013 till 2015. Utbildningen gavs på uppdrag av Socialstyrelsen och omfattade 30 högskolepoäng med två års studier på kvartsfart. Samtliga studerande var yrkesverksamma som chefer och ledare inom kommunal eller privat äldreomsorg i södra Sverige. Metoder som använts i bearbetning och analys av materialet är deskriptiva, jämförande och analytiska med regressionsmodeller och SEM-analys.

    Resultatet visar på att cheferna – oavsett utbildningsbakgrund, värderade följande etiska värden högst: att inte skada, respekt för individen och rätten till konfidentialitet. Värdedilemman i chefsarbetet är dock vanligt och sammanlänkat med andra utmaningar i arbetet, särskilt med utmaningar som rör hantering över organisationsnivåer (buffertproblem och containerproblem) och av olika ansvarsområden (logikkonflikter). Inom privat verksamhet skattade de medverkande cheferna värdekonflikter och andra utmaningar i lägre grad än chefer inom kommunal verksamhet.

    De flesta chefer var nöjda med hur de kunde fullfölja sitt ansvar för utveckling av verksamheten avseende värdegrund, kvalitet, processer, dagligt arbete, brukarmedverkan, brukarsäkerhet och arbetsmiljö. De flesta skattade också att de arbetade i mycket hög grad med strukturering och utveckling av dessa frågor.

    Stödresurser minskade upplevelsen av värdekonflikter, men det fanns skillnad i betydelsen relaterat till chefers grundprofession. Det organisatoriska stödet var också tydligare för chefer inom privat verksamhet. Organiserade stödresurser hade stor betydelse för hållbart integrerat och värdeskapande ledarskap samt för aktiva ledningsstrategier. Även sambandet mellan hållbart ledarskap och aktiva ledarstrategier modererades av grundprofession, där sambandet var moderat negativt för chefer med social grundutbildning. Det tycks således finnas ett utbildningsbehov bland äldreomsorgens chefer och behov av ett utvecklat stöd från arbets- HÖGSKOLAN BORÅS HÖGSKOLAN BORÅS 15 givaren då det varierar avseende omfattning, inriktning och nivå mellan kommunal och privat verksamhet.

    Sammanfattningsvis har chefer i äldreomsorgen många olika värden, på olika nivåer och utifrån olika perspektiv att förhålla sig till i sitt ledarskap. Att hantera och utveckla förståelse för dessa är utmanande i chefskapet och värdedilemman är vanliga. Majoriteten av cheferna i denna studie beskriver dock generellt en aktiv och god hantering och organisering av dessa. Konstateras att en integrerad förståelse och hantering, samt goda organisatoriska stödresurser tycks bidra till mer hållbart och värdeskapande ledarskap.

    Fulltekst (pdf)
    fulltext
1234567 51 - 100 of 533
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf