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- Boström, Jonas
(author)
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Knowledge for Improving Healthcare Service Quality : Combining Three Perspectives
- 2020
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Licentiate thesis (other academic/artistic)abstract
- The Swedish public sector in general, and healthcare specifically, is struggling with large deficits: 19 of 21 regions have large negative results in 2019. The demands made by the citizens and their elected politicians that healthcare should offer effective, accessible, good and equal care are difficult to meet. However, when it comes to emergency care, Swedish healthcare scores high on international rankings. The difficulties and challenges today lie in ensuring good and equal care for the large groups of people with multiple illnesses, and patients who need long-term care from different healthcare providers. A complicated system has become even more complex.Organizational research has shown conflicts between different ways of working to improve and change the organization and the methods that support the daily work of providing healthcare services. Furthermore, quality research shows that there are knowledge gaps to be filled when it comes to understanding how complex problems should be handled and what kind of knowledge could contribute. This also applies to the tensions and conflicts that can arise when knowledge from patients, other professions and fields of knowledge must be integrated with the knowledge that the professions (physicians, nursing) possess. Several public organizations have in recent years also adopted methods, tools and approaches from the design field. Especially user involvement (human-centric), collaboration and visualization. Design research often highlights the methods which are favorable for handling complexity.The overall purpose of this thesis was therefore to gain a deeper understanding of how the quality development work in healthcare is expressed and how it is affected when different perspectives of knowledge are integrated - with a focus on improvement knowledge, professional knowledge and design thinking. Since the purpose of the licentiate thesis was to gain a deeper understanding of what happens when new knowledge to develop quality in healthcare emerges, the method is based on a qualitative approach. Three research questions were formulated and led to three studies. The first study, a literature review, showed that there is limited research in the area but that there are indications that user involvement in development work affects employees' attitudes and values. In study number two, a case study was set up using design methods and involving users. The results showed tensions between the improvement work and the daily clinical operations. This tension could primarily be attributed to the conflict between faster and slowerxviprocesses (doing and thinking), when moving between different practicing skills (design, improvement and professional). The last study aimed to understand more about the management's view of this, relatively new knowledge (design) in healthcare, in relation to the traditional way to work with improvement and change. The result stresses that there are potential conflicts between the different fields of knowledge. But the interviews were also interpreted as showing the synergy effects that can arise when different practitioners meet, and the results also show that different ways of thinking can challenge the traditional ways of handling improvement and change in the development of healthcare.The thesis result overall strengthens the research that shows that design can add another dimension to traditional improvement work in healthcare. However, there is also frustration about something which is perceived as more abstract and reflective and which can sometimes be slower than what the solutions-oriented professions, who work under great time pressure and with scarce resources, are used to. Furthermore, the thesis highlights the problem that also has been described in previous research and which signals the (in)ability to both share new knowledge and to absorb it.
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- Bäckström, Ingela, 1963-, et al.
(author)
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A health‐related quality management approach to evaluating health promotion activities
- 2012
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In: International Journal of Quality and Service Sciences. - : Emerald. - 1756-669X .- 1756-6703. ; 4:1, s. 76-85
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Journal article (peer-reviewed)abstract
- Purpose – The purpose of this paper is to describe health promotion activities accomplished within a project and to measure the conditions for sustainable health within the case organizations. Also, the purpose is to test a previously developed measurement approach, which measures health-related quality management.Design/methodology/approach – A health promotion project currently being carried out at eight Swedish elementary schools has been studied. In earlier research a measurement approach was developed to measure health-related quality management. The approach was handed out to the co-workers at the eight different schools in the initial stage of the project. The leaders at the schools were informed of the results of their own school and the mean value of all the eight schools. The consistency and reliability of the statements within the approach was tested.Findings – A description of health promotion activities accomplished and planned within the project can be found. The results from the measurement of the health-related quality management in the eight schools are presented, together with the mean score of all schools. The test of the measurement approach is presented and discussed.Originality/value – A description of health promotion activities can help managers and project leaders to plan and carry out valuable health promotion activities in their striving for both sustainable health among the co-workers and efficient organizations. This measurement approach can help managers and project leaders to measure the effects of the health promotion activities
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- Bäckström, Ingela, 1963-, et al.
(author)
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A Hospital Without Departments?
- 2022
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In: Proceedings M2D2022. - 9789895475629 - 9789895475636 ; , s. 957-958
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Conference paper (peer-reviewed)abstract
- Increasing the efficiency of patient treatment as well as improving patient care quality and reducing waiting times are challenges facing healthcare systems around the world (Fine, et al., 2009). Furthermore, there is a challenge to increase the number of patients treated and to cut waiting times while retaining costs under control as well as becoming a more attractive employer (van Rossum et al., 2016). In order to meet the challenges in healthcare, different Quality Management (QM) initiatives have been applied (Seidl and Newhouse,2012). Lean and Six Sigma are popular QM initiatives originating from manufacturing but also used in the healthcare sector. Six Sigma and Lean can be used to detect value adding processes and also confirming control and sustainability of change through establishing plans (ibid). The purpose of this paper is to describe a shared picture of the situation and to identify general possibilities for improvements focusing on the transitions between wards.
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- Bäckström, Ingela, 1963-, et al.
(author)
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A Model For Creating A Shared Picture Of Customer Expectations
- 2022
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In: The 25th Excellence in Services International Conference.
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Conference paper (peer-reviewed)abstract
- The purpose of this paper was to present a model for creating a shared picture of customer expectations within an organization based on both internal and external perspectives. Methodology: A model was developed in a joint research project between a municipality and the university in a series of workshops followed by discussions and analysis with researchers and project members. The model and its components were designed, tested, and redesigned throughout the whole project. Main Findings: A model based on the PDSA-cycle with components including instructions and templates how to work with capturing perceived customer value, customer expectations and missing value and conduct value analysis, gap analysis and continuous improvements. Practical implications: A model that can be adapted to every organization who wants to create a shared picture of the customer, customer expectations and then base the work with improvements from customers’ expectations. Originality/value: A model for none profit organizations to identify values they provide to the citizens, as well as examine if they fulfill citizens expectations. Through the model find areas for continuous improvement in the endeavor to create value for customers.
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- Bäckström, Ingela, 1963-, et al.
(author)
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A proposed model for developing quality and efficiency in transitional care
- 2023
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In: The TQM Journal. - 1754-2731 .- 1754-274X. ; 35:9, s. 107-122
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Journal article (peer-reviewed)abstract
- Purpose – The purpose of this study is to develop a model describing different factors that affect quality andefficiency in transitional care.Design/methodology/approach – A meta-synthesis focusing on the transitions between wards wasconducted within a research project. The results from eight studies within that research project have beencombined and analysed from a holistic view.Findings – The findings are a model with a description of seven different categories consisting of the identifiedfactors affecting quality and efficiency in transitional care. Those categories are (1) learning organisation,(2) standardising and structuring, (3) applying a holistic view, (4) understanding organisational culture in ahealth care context, (5) management and leadership, (6) for whom value is created and (7) working together. The results from the study have been verified in previous research.Research limitations/implications – The result of the completed meta-synthesis is based on studiesconducted at two medium-sized hospitals in Sweden. The developed model can be used in a similar context toimprove quality and efficiency in patient transfers by management and employees working based on thevarious factors.Originality/value – This model describes factors (success factors, prerequisites, conditions and lack thereof) affecting the ability to achieve quality and efficiency in transitional care that can be used in future research aswell as for practical improvements.
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- Bäckström, Ingela, 1963-, et al.
(author)
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Are healthy and successful organizations working accordingly to Quality Management?
- 2009
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In: International journal of workplace health management. - : Emerald. - 1753-8351 .- 1753-836X. ; 2:3, s. 245-257
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Journal article (peer-reviewed)abstract
- Purpose The purpose of this paper is to examine if healthy and successful organizations are working accordingly to Quality Management. The purpose is also to describe in more detail how they are working. Methodology/Approach Three Swedish organizations that have shown excellence in leadership, internal partnership, working environment and profitability have been examined, to find out what methodologies they have used for their success. To discover whether these healthy and successful organizations are working accordingly to Quality Management, Deming’s 14-point list has been used as an analytical tool. Findings Identified methodologies used by the healthy and successful organizations are described. Viewed in the light of our analysis, a relationship between the three examined healthy and successful organizations and Quality Management is indicated. Practical implications Working with the methodologies described in the paper, the three organizations have improved co-worker health. Other organizations could probably adopt the identified and described methodologies to improve the health of their co-workers and effectiveness in the organization. Originality/value Concerning the performance evaluation and the continuous improvement component in Quality Management, substantial contributions could be made to the health area by applying the tools that the quality area have used over a considerable period to improve the quality outcomes. Quality and health aspects have common success factors, and a focus on high quality could be seen as positive for health outcomes.
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