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1.
  • Böling, Susanna, et al. (författare)
  • No ordinary consultation : a qualitative inquiry of hospital palliative care consultation services
  • 2020
  • Ingår i: Journal of Health Organization and Management. - : Emerald Group Publishing Limited. - 1477-7266. ; 34:6, s. 621-638
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose – Considering the great need for palliative care in hospitals, it is essential for hospital staff to havepalliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care.However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need forfurther knowledge about the process of palliative consultations. The purpose of this study therefore was toexamine how palliative consultations in hospitals are practised, as perceived by consultants and health careprofessionals on receiving wards.Design/methodology/approach – Focus groups with palliative care consultation services, health carepersonnel from receiving wards and managers of consultation services. Interpretive description and constantcomparative method guided the analysis.No ordinaryconsultationThe authors would like to thank participating colleagues for sharing their knowledge and experiencesabout palliative consultations.Ethics approval and consent to participate: The project received ethical approval from the SwedishEthical Review Authority, No. 809–16. Informed consent preceded participation for all of the participants.Consent for publication: Not applicable.Availability of data and material: The datasets generated and analysed during the current study are notpublicly available due to the inclusion of potentially sensitive individual data about health status. Theethical approval includes a statement that the data will be kept in a private repository but are availablefromthe corresponding author on reasonable request.Funding: Sahlgrenska Academy at the University of Gothenburg.Authors' contributions: JO, HB and JB planned the study. All authors conducted focus group €interviews. Analysis and interpretation of focus group data was performed by SB with support from JO, €HB and JB. SB wrote the first draft of the manuscript, JO, HB and JB commented on the manuscript and €contributed to the final version. The final manuscript was read and approved by all authors.Competing interests: The authors declare that they have no competing interests.The current issue and full text archive of this journal is available on Emerald Insight at:https://www.emerald.com/insight/1477-7266.htmReceived 14 April 2020Revised 24 June 2020Accepted 2 July 2020Journal of Health Organization andManagement© Emerald Publishing Limited1477-7266DOI 10.1108/JHOM-04-2020-0130Findings – Variations were seen in several aspects of practice, including approach to practice and representedprofessions. The palliative consultants were perceived to contribute by creating space for palliative care,adding palliative knowledge and approach, enhancing cooperation and creating opportunity to amelioratetransition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultationservices utilised proactive practices that took the initiative in relation to the receiving wards.Originality/value – A lack of policy and divergent views on how to conceptualise palliative care appeared tobe associated with variations in consultation practices, tentative approaches and a bottom-up drivendevelopment. This study adds knowledge, implying theoretical transferability as to how palliative careconsultations can be practised, which is useful when designing and starting new consultation services.
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2.
  • Böling, Susanna, et al. (författare)
  • No ordinary consultation - a qualitative inquiry of hospital palliative care consultation services
  • 2020
  • Ingår i: Journal of Health Organization and Management. - 1477-7266. ; 34:6, s. 621-638
  • Tidskriftsartikel (refereegranskat)abstract
    • Considering the great need for palliative care in hospitals, it is essential for hospital staff to have palliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care. However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need for further knowledge about the process of palliative consultations. The purpose of this study therefore was to examine how palliative consultations in hospitals are practised, as perceived by consultants and health care professionals on receiving wards.Focus groups with palliative care consultation services, health care personnel from receiving wards and managers of consultation services. Interpretive description and constant comparative method guided the analysis.Variations were seen in several aspects of practice, including approach to practice and represented professions. The palliative consultants were perceived to contribute by creating space for palliative care, adding palliative knowledge and approach, enhancing cooperation and creating opportunity to ameliorate transition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultation services utilised proactive practices that took the initiative in relation to the receiving wards.A lack of policy and divergent views on how to conceptualise palliative care appeared to be associated with variations in consultation practices, tentative approaches and a bottom-up driven development. This study adds knowledge, implying theoretical transferability as to how palliative care consultations can be practised, which is useful when designing and starting new consultation services.
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3.
  • Carlström, Eric, et al. (författare)
  • Inter-Organisational Exercises in Dry and Wet Context : Why Do Maritime Response Organisations Gain More Knowledge from Exercises at Sea Than Those on Shore?
  • 2020
  • Ingår i: Sustainability. - 2071-1050 .- 2071-1050. ; 21:14
  • Tidskriftsartikel (refereegranskat)abstract
    • : This is a study of inter-organisational exercises arranged by on-shore organisations (ONSOs)and off-shore organisations (OFFSOs). The aim was to compare findings from trained emergencystaffs' perceptions of the impact of exercises. The data were retrieved from surveys conducted bythe research team in conjunction with exercises. The surveys included staff from the coast guard,sea rescue, police department, fire department and ambulance services. A total of 94 professionalemergency personnel participated in the ONSO exercises and 252 in the OFFSO exercises. The studywas based on the suggestion that collaborative elements during an inter-organisational exercisepromote learning, and learning is important to make the exercises useful. Collaboration proved to bea predictor for some of the items in learning, and learning was a predictor for some of the items inutility. There was, however, a stronger covariation between collaboration, learning and utility in theOFFSOs exercises than in the ONSOs. One reason might be the different cultures of emergency staffinvolved in on-shore and off-shore organisations. The OFFSOs' qualifications may be dominated byseamanship, together with professional practice, and all parties are expected to act as first responders.ONSOs, on the other hand, practice exercises from a strict professional and legal perspective.
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4.
  • Hernborg, Martin N., et al. (författare)
  • First initiatives in prehospital care : Basing assessments on incomplete preliminary information
  • 2020
  • Ingår i: Journal of Nursing Education and Practice. - 1925-4040 .- 1925-4059. ; 0:6, s. 47-54
  • Tidskriftsartikel (övrigt vetenskapligt)abstract
    • Rationale and aim: Ambulance staff, i.e. registered nurses and assistant nurses, receive assignments from emergency dispatch centres including information on level of priority, address and patient’s care requirements. One problem is that the preliminary information the dispatcher gives to the ambulance staff may be incomplete. The purpose of this study was to determine how ambulance staff base their assessments on incomplete preliminary information when assessing care requirements.Methods: Fifteen ambulance staff working at seven ambulance stations were interviewed for this study. Interviews were transcribed and analysed using content analysis.Results: Incomplete preliminary information means that ambulance staff may be misdirected. This means that if the preliminary information from the dispatcher is incomplete, the ambulance staff need to reassess, and this is perceived to be difficult. Ambulance staff tend to stick to the first initiative that is taken after they receive an alert from the dispatcher.Conclusions: When ambulance staff receive incomplete preliminary information, they need to consider the possibility of conducting a reassessment. Based on the results, there is a need for new procedures to improve preparedness to conduct a reassessment after receiving incomplete preliminary information.
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5.
  • Jansson, Magnus, 1970, et al. (författare)
  • Drivers of outsourcing and backsourcing in the public sector — From idealism to pragmatism.
  • 2020
  • Ingår i: Financial Accountability & Management. - 0267-4424 .- 1468-0408.
  • Tidskriftsartikel (refereegranskat)abstract
    • Local governments are bringing previously outsourced services back in‐house. Research into explanations for sourcing decisions in the public sector is growing, however, few researchers have investigated drivers of both outsourcing and backsourcing in local public‐governance organizations. In this study we utilize transaction cost economic theory (TCE) and political ideology to investigate underlying motives of sourcing in local public governance organizations. Based on a 2018 survey of chief financial officers (CEO) in all of Sweden's 290 municipalities, this study shows that backsourcing is strongly associated with outsourcing and that outsourcing and backsourcing should not be understood as opposite phenomena, rather as interdependent phenomena in a dynamic sourcing strategy. Outsourcing and backsourcing are driven in part by different factors: Outsourcing by political ambitions and economic factors relating to TCE, while managerial and pragmatic concerns are foregrounded for backsourcing.
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6.
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7.
  • Nord Ljungquist, Helena (författare)
  • VEM HAR OCH TAR ANSVAR! : – I Väntan På Ambulans (IVPA)-uppdrag i Glesbygdsmiljö
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Aim: The overall aim was to explore and describe experiences from the perspective of different actors in While Waiting for Ambulance (WWFA) assignments in a rural environment. The four studies aimed: to describe WWFA and ambulance assignments in rural environments, focusing on frequency, event time and actions of firefighters before an ambulance arrives at the scene, and to evaluate these actions (I); to describe emergency situations involving  WWFA assignment in a rural environment from the caller´s perspective (II); to describe compliance with the telephone-assisted cardiopulmonary resuscitation (T-CPR) protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions (III); to describe WWFA assignment in a rural environment from the firefighters’ and the ambulance staff’s perspective (IV).Methods: The studies had a descriptive and comparative design. They were analysed with a qualitative and quantitative methods.Results: In event time showed the process time between ambulance staff and firefighters as significantly statistically different, to firefighters' disadvantage. Nevertheless, firefighters arrived first at the scene for 95 % of assignments after 17 minutes in the median, while ambulance staff took nearly twice the time. Access to help in the immediate area is experienced as valuable to the callers, but there is also a sense of being lone and lonely with vulnerability. Instructions from T-CPR protocol were difficult to comply with both from EMDs and laypersons, especially airway control. Regardless of the quality of communication between EMD and lay people, performance of CPR did not improve. Firefighters and ambulance staff experienced a directedness of responsibility towards affected persons; simultaneously, they were each other’s support. WWFA assignment is, itself, in a gray zone between the involved organisations, and strategies are lacking for the assignment.Conclusions: WWFA assignments are an underutilized resource in individual’s local environments, where a coordinated picture of identified organisational gray zones provide better conditions for future action by the organisations involved, with increased opportunities to save lives in people's local environments.
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8.
  • Raidla, Annelie, et al. (författare)
  • Outcomes of Establishing an Urgent Care Centre in the Same Location as an Emergency Department
  • 2020
  • Ingår i: Sustainability. - : MPDI. - 2071-1050. ; 12:19
  • Tidskriftsartikel (refereegranskat)abstract
    • The emergency department (ED) is one of the busiest facilities in a hospital, and it is frequently described as a bottleneck that limits space and structures, jeopardising surge capacity during Major Incidents and Disasters (MIDs) and pandemics such as the COVID 19 outbreak. One remedy to facilitate surge capacity is to establish an Urgent Care Centre (UCC), i.e., a secondary ED, co-located and in close collaboration with an ED. This study investigates the outcome of treatment in an ED versus a UCC in terms of length of stay (LOS), time to physician (TTP) and use of medical services. If it was possible to make these parameters equal to or even less than the ED, UCCs could be used as supplementary units to the ED, improving sustainability. The results show reduced waiting times at the UCC, both in terms of TTP and LOS. In conclusion, creating a primary care-like facility in close proximity to the hospitals may not only relieve overcrowding of the hospital's ED in peacetime, but it may also provide an opportunity for use during MIDs and pandemics to facilitate the victims of the incident and society as a whole.
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9.
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10.
  • Berlin, Johan, 1975- (författare)
  • Teamarbete
  • 2019. - 2. upplagan
  • Ingår i: Sjuksköterskans kärnkompetenser. - Stockholm : Liber. - 9789147128020 ; , s. 139-158
  • Bokkapitel (övrigt vetenskapligt)
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11.
  • Carlström, Eric D., 1957-, et al. (författare)
  • Collaboration Exercises in Emergency Work : Outcomes in Terms of Learning and Usefulness
  • 2019
  • Ingår i: Disaster, Diversity and Emergency Preparation. - Amsterdam : IOS Press. - 9781614999935 ; , s. 147-154, s. 147-154
  • Bokkapitel (refereegranskat)abstract
    • In this study we reviewed scientific papers which measured the effect of collaboration exercises in terms of learning and usefulness. The question to be answered was: Do collaboration exercises contribute to learning that is useful in actual emergency work? The point of departure was the perception that exercises improve handling logic and actions that increase security and safety in the community. However, the organizations involved in emergencies are regarded as inflexible, conservative, and non-collaborative. Data was collected in three steps. In the first step, studies of collaboration exercises in a crisis context were selected. In the next step, studies focused on the outcome of collaboration exercises in terms of learning and usefulness were identified. Out of 564 articles, seven were selected. The data from all included articles was collected by a common questionnaire in the included studies. The instrument measured learning and usefulness on a 5-point Likert scale, from strongly disagree to strongly agree. A total of 477 participants responded to the surveys. The mean within the learning dimension was 3.54 (SD = 0.62), and the mean within the usefulness dimension was 3.64 (SD = 0.65). The results showed that a developed type of exercise that included room for seminars resulted in a higher degree of learning and usefulness than the rest of the exercises studied.
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12.
  • Szücs, Stefan, et al. (författare)
  • Coping with Citizens and Stress : Interaction Strategies during Public Service Delivery within Health Care, the Police, and Social Work
  • 2019
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • Previous research and theory suggests that frontline workers adapt to workload-related stress in a number of ways, interacting towards or away from citizens, or even against citizens, but what are the actual practices of coping, and how is coping related to stress? The data comes from a web-survey sent to 990 public sector frontline workers in West Sweden during 2018 within the police, health care psychiatry, and social work organizations. The findings show that there are significant differences in stress: highest average level among social workers, followed by police officers, and heath care psychiatry. Four ways of moving towards clients – through prioritizing motivated clients, rule bending/breaking, instrumental action, or using personal resources – and three ways of moving away from clients – through aggression, by rationing, or routinizing – are revealed (H1). Prioritizing and aggression are most common within the police, rule bending/breaking and routinizing in social work, and instrumental action within health care (H2), but only instrumental action does not significantly increase stress, on top of individual characteristics and organizational demands and resources (H3).
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13.
  • Szücs, Stefan, 1964, et al. (författare)
  • Coping with Citizens and Stress: Interaction Strategies during Public Service Delivery within Health Care, the Police, and Social Work
  • 2019
  • Ingår i: 3rd Street-level Bureaucracy Conference, Aalborg University, Copenhagen, June 11-13..
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • Previous research and theory suggests that frontline workers adapt to workload-related stress in a number of ways, interacting towards or away from citizens, or even against citizens, but what are the actual practices of coping, and how is coping related to stress? The data comes from a web-survey sent to 990 public sector frontline workers in West Sweden during 2018 within the police, health care psychiatry, and social work organizations. The findings show that there are significant differences in stress: highest average level among social workers, followed by police officers, and heath care psychiatry. Four ways of moving towards citizens – through prioritizing motivated clients, rule bending/breaking, instrumental action, or using personal resources – and three ways of moving away from citizens – through aggression, by rationing, or routinizing – are revealed. Prioritizing and aggression are most common within the police, rule bending/breaking and routinizing in social work, and instrumental action within health care, but only instrumental action does not significantly increase stress, on top of individual characteristics and organizational demands and resources.
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14.
  • Böling, Susanna, et al. (författare)
  • Rethinking Consultation - Investigating the Perceived Work Models of a Palliative Consultation Team
  • 2018
  • Ingår i: Palliative Medicine : A Multiprofessional Journal. Vol. 32, Suppl. 1. Abstract PO38. - 0269-2163 .- 1477-030X.
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • Background: Previous research has shown that palliative consultation in hospital contexts sometimes face multifaceted challenges. Possibly creat- ing barriers between the consulting team and patients in need of palliative care. Hence, there is a need to consider how we implement and perform palliative consultation to inform future initiatives. This study is part of an ongoing project with the aim to analyse the discourse around implement- ing palliative care in a hospital context. Aim: The aim of this study was to identify and analyse various work models applied in a hospital context by a palliative consultation team. Method: Repeated focus group discussions with a palliative consultation team and its managers. A total of six focus group discussions were held from April 2016 to June 2017. The focus groups were audio recorded and transcribed verbatim. The data was read and analysed; identifying and categorising different work models. Result: According to what was expressed in the focus groups there were variations in how the consultation team operated in different hospital units and wards. Consulting as a team, consisting of a nurse, social worker and physician, was emphasised. One of the significant features was that they visited several wards on a weekly basis without receiving formal referrals beforehand. Although varying in form, the visits shared the function of being a forum for the wards to raise questions regarding palliative care relating to specific patients with palliative needs. Furthermore, during the introduction of consultation in some of the wards, the consultation team chose to designate time where a nurse from the team were present in the ward and among other things; identified patients with palliative care needs together with the ward staff and paved the way for the weekly palliative consultation.
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15.
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16.
  • Khorram-Manesh, Amir, et al. (författare)
  • Emergency Management and Preparedness Training for Youth (EMPTY) : The Results of the First Swedish Pilot Study
  • 2018
  • Ingår i: Disaster Medicine and Public Health Preparedness. - 1935-7893 .- 1938-744X. ; 12:6, s. 685-688
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To examine the impact of a simulation training in raising a group of young students' personal and situational awareness in disasters and emergencies.METHODS: In total, 25 young students participated in two simulation scenarios representing two actual events, fire, and shooting, using a combination of two validated simulation training (Emergency Management and Preparedness Training for Youth [EMPTY]). The changes in their knowledge and awareness were evaluated by using questionnaires and the whole simulation was evaluated by three independent observers and a reference group.RESULTS: New concepts of emergency management, for example, evacuation, and barricading, could be trained in a safe environment. There was a significant increase in students' personal and situational awareness and their active engagement in the management of emergencies.CONCLUSION: EMPTY could raise the youth basic knowledge and ability to understand the concept of preparedness by being mentally prepared, available for collaboration, gaining a higher confidence, understanding the physical and psychological consequences of a major incident and the importance of their own safety. (Disaster Med Public Health Preparedness. 2018; page 1 of 4).
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17.
  • Mörndal, Marie, 1955- (författare)
  • "Vi måste takta!" : En studie av organisering för samverkan.
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Organizational collaboration is perceived as a positive phenomenon in the public sector and is often seen as a way of facing societal challenges despite limited resources. This positive view on organizational collaboration seems to persist, although research shows that collaborative projects bring various difficulties. These are related to boundaries, both between organizations and professions. How boundaries are understood and managed are thus central aspects of organizing for collaboration. This thesis describes and discusses the preparation – the organizing – for collaboration and the purpose of the thesis is to explore and deepen an understanding of the practice developed in organizing for collaboration.A municipality’s work to improve internal collaboration and prepare for external collaboration has been studied. The work was led by two project managers in collaboration with various members of the municipality. A practice-oriented approach has been applied, which involves a focus on the activities carried out during the organizing work. The empirical material was created through participatory observations of the project managers’ work.The project managers’ practice developed into five activity patterns called planning, navigating, interacting, documenting and, what in Swedish was called, “takta”. The term “takta” was used to denote activities related to adaptation and synchronization to the municipality’s activities; to pace the activities.The analysis shows that the activity pattern of pacing was a superior activity pattern that managed and organized the other four patterns. The concept pacing contributes to the understanding of how activities create rhythms in an organization and how these are adapted to the overall pace. People responsible for pacing must be aware of the rhythms of other activities that affect the pacing. Pacing is a complex concept that can be described in several dimensions: temporal, social, boundary-crossing, emotional, holistic, and in a situated dimension. These dimensions contribute to the understanding of how pacing is done, what it means when pacing and also facilitate an analysis when pacing fails.The conclusion of the thesis is that an awareness of pacing activities in organizing across boundaries increases the opportunities to implement activities in the “right” order, time and place. Thus, the multidimensional concept of pacing may be used as a planning-tool when organizing across boundaries and as an analytical instrument when the organizing becomes unsynchronized with other activities. A practice-oriented perspective enables the exploration of the activity patterns created in organizing for collaboration and increases the understanding of how organizing across boundaries is done.
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18.
  • Abelsson, Anna, 1971- (författare)
  • Simulering som lärande inom prehospital akutsjukvård
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Den prehospitala akutsjukvården är ett komplext kunskapsfält som innebär att vårdaren skall kunna bemöta patient och närstående, bedöma skada, sjukdom och den aktuella situationen samt avgöra vilka vårdåtgärder som skall prioriteras.Patientens lidande kan lindras genom att vårdaren tränar färdigheter i ett prehospitalt kontext. Detta främjar en god och säker vård samt stärker patientens möjligheter till överlevnad.Resultatet visar på behovet av simulering inom prehospital akutsjukvård. Med simulering lär sig vårdaren att hantera realistiska, dynamiska och komplexa vårdsituationer, vilket skapar kunskaper, färdigheter och erfarenheter av omhändertagande av patient drabbad av högenergitrauma. Simuleringens utformning och miljö skapar förutsättningar för lärandet vilket framkommer i interventionsstudien.Utifrån resultatet i föreliggande forskning utvecklas en modell för lärande med hjälp av simulering.
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19.
  • Alvebratt, Catrin, et al. (författare)
  • A new working method in psychiatric care - the impact of implementation.
  • 2017
  • Ingår i: International Journal of Public Administration. - 0190-0692. ; 40:3, s. 295-304
  • Tidskriftsartikel (refereegranskat)abstract
    • An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.
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20.
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21.
  • Berlin, Johan, 1975, et al. (författare)
  • Sjuksköterskan som chef och ledare
  • 2017
  • Ingår i: Sandberg H. (red). Pedagogik för sjuksköterskor. - Lund : Studentlitteratur. - 9789144093956
  • Bokkapitel (refereegranskat)
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22.
  • Löfström, Mikael, 1960-, et al. (författare)
  • Hur implementerar chefer samverkan?
  • 2017
  • Ingår i: Kommunal ekonomi. - Vallentuna. ; :4, s. 31-32
  • Tidskriftsartikel (populärvet., debatt m.m.)
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23.
  • Alverbratt, Catrin, et al. (författare)
  • A New Working Method in Psychiatric Care : the impact of implementation
  • 2016
  • Ingår i: International Journal of Public Administration. - 0190-0692 .- 1532-4265. ; 40:3, s. 295-304
  • Tidskriftsartikel (refereegranskat)abstract
    • An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.
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24.
  • Berlin, Johan, 1975- (författare)
  • Artefakters organiserande funktion
  • 2016. - 2:a
  • Ingår i: Team i vård, behandling och omsorg. - Lund : Studentlitteratur AB. - 9789144107691 ; , s. 227-248
  • Bokkapitel (refereegranskat)
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25.
  • Berlin, Johan, 1975-, et al. (författare)
  • Chefers strategier för att implementera samverkan
  • 2016
  • Ingår i: Nationella kommunforskningsprogrammet. - Göteborg : Kommunforskning i västsverige (KFi).
  • Rapport (refereegranskat)abstract
    • Den här studien handlar om interorganisatorisk samverkan inom vård och omsorg. Här studeras vilka strategier som första och andra linjens kommunala chefer använder för att få till stånd en fungerande samverkan. Hur ser hindren ut och vilka strategier och överväganden gör cheferna för att övervinna dem. Den fråga som därför behandlas i denna rapport är; vilka strategier an-vänder kommunala chefer inom vård och omsorg för att implementera samverkan? I studien har data samlats in genom att 21 chefer inom vård och omsorg intervjuats. De chefer som medverkat i studien har alla varit verksamma i kommuner som deltagit i det Nationella kommunforskningsprogrammet, vilka är Borås, Göteborg, Lund, Norrköping, Piteå, Sjöbo och Stockholm. I studien har tre centrala iakttagelser gjorts. Dessa handlar om; 1) att cheferna väljer en form av situationsanpassad strategi beroende på vad sam-verkan har för syfte och med vilka aktörer som samverkan ska genomföras, 2) att cheferna behöver hantera den upplevda intressekonflikten som finns mellan att ta ansvar för den "egna verksamheten" samtidigt som de förväntas ta ansvar för samverkan med andra organisationer och 3) att cheferna har svårt att hantera sitt chefsansvar vid samverkan. Samverkan där linjestyrningen utmanas eller kompletteras med horisontell styrning är lösare reglerad vilket kan leda till oklar ansvarsfördelning och diffus arbetsdelning. Här kan chefer behöva tillägna sig andra uttryck för att utöva sitt ledarskap då den traditionella chefsrollen inte är lika väl anpassad till styrning vid samverkans-situationer.
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26.
  • Hellman, Stefan, 1975- (författare)
  • Förändringsprogram i hälso- och sjukvården : Nätverkskonstruktioner som möjliggör och försvårar införandet av lean
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Within the public sector great change efforts are currently made to meet future challenges. In the area of health care, change initiatives are implemented to enhance quality and efficiency. To this end, a lean change programme is being widely introduced in Sweden as well as internationally. The overriding aim of this study is to increase knowledge of what happens when change programmes, CP, such as lean are implemented in a healthcare organisation, HCO.Previous research has shown that the main obstacle to implementing CP in HCO:s is their complexity. However, the complexity has often been reduced, as different factors such as management, professions, organisation and control have been studied separately. To fully capture the complexity of the HCO the Actor Network Theory, ANT, was used in this study. In line with ANT, introducing lean can be described in terms of a translation process in which human and non-human actors are woven into a network. This approach allows for the incorporation of various factors in the study of a change process in a complex organisation. Drawing on ANT, this thesis explores how network constructions enable or impede change programmes.The approach is based on ethnographic monitoring of the implementation of lean in the Värmland county council public healthcare organisation. As a result of the holistic perspective, the study provides detailed descriptions of how complexity impacts on the implementation. It displays the relations enabling or impeding the implementation of CP and the methods actors use to establish and defend the relations.The contribution of the study is threefold. Empirically, the study monitors a HCO aiming to implement full-scale lean as philosophy, principle and tool. Methodologically, the study evaluates ANT as a methodological theory to study CP in a HCO. Finally, the domain-specific contribution of the study is its identification of the relations and methods that impact on lean deployment. 
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27.
  • Khorram-Manesh, Amir, 1958-, et al. (författare)
  • Two Validated Ways of Improving the Ability of Decision-Making in Emergencies : Results from a Literature Review
  • 2016
  • Ingår i: Bulletin of Emergency and Trauma. - : STrauma Research Center, hiraz University of Medical Science. - 2322-2522 .- 2322-3960. ; 4:4, s. 186-196
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.
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28.
  • Khorram-Manesh, Amir, 1958, et al. (författare)
  • Two Validated Ways of Improving the Ability of Decision-Making in Emergencies; Results from a Literature Review
  • 2016
  • Ingår i: Bullentin of Emergency and Trauma. - 2322-2522 .- 2322-3960. ; 4:4, s. 186-196
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.
  •  
29.
  • Nordström, Erik (författare)
  • Samordnad individuell plan (SIP) : Professionellas samt barn och föräldrars erfarenheter
  • 2016
  • Licentiatavhandling (övrigt vetenskapligt)abstract
    • Introduktion. Många barn och unga idag har så pass komplexa behov att de behöver samtidiga insatser från olika huvudmän. Insatserna blir alltmer specialiserade och fragmenterade, vilket kräver att professioner inom hälso- och sjukvård, socialtjänst och skola samverkar. Det finns också ett lagstiftat krav sedan 2010 på samverkan i form av Samordnad individuell plan (SIP). SIP möjliggör för barn och föräldrar att få överblick och få samordnade insatser av hälso- och sjukvården och socialtjänsten genom möte, planering och dokumenterade insatser.Syftet med avhandlingen var att beskriva professionellas, barn och föräldrars erfarenhet av samordnad individuell plan (SIP).Design och metod. Två deskriptiva studier genomfördes i ett län i södra Sverige. Delstudie 1 bestod av tolv fokusgruppsintervjuer med sammanlagt 71 personer med olika yrkeskategorier inom hälso- och sjukvården, socialtjänsten och skolan. Delstudie 2 bestod av semi-strukturerade intervjuer med sammantaget tretton barn och föräldrar från olika familjer. Bägge studierna analyserades med kvalitativ metod.Resultat. Resultatet i delstudie 1 visar att verksamheterna gör en primär avvägning mellan samverkan och sitt respektive kärnuppdrag; vårdande, pedagogisk och utredande. Samverkan skedde genom en pendling mellan hindrande och främjande faktorer. Hindrande faktorer består av olika mandat och behov, tvång till närvaro, ifrågasättande och klander, samt tidsramar och prioriteringar. Främjande faktorer är likartad tolkning av gemensamma avtal, ömsesidig respektoch kollegialt lärande, gemensam terminologi och dokumentation, samt intresse för samverkan. Delstudie 2 visar att barn och föräldrars upplevelse av delaktighet i form av SIP ökade över tid och att de över tid upplevde att de fick ett samordnat stöd från olika vårdgivare, som barnen och/eller föräldrarna innan SIP ofta själva fick samordna. Detta mål uppnåddes först efter initialt motstånd och konkurrens mellan olika verksamheter, och det underlättade att skapa relationer och allianser med professionella för att nå detta mål. Resultatet diskuteras utifrån fyra olika stadier av samverkan och förutsättningar för att intentionerna med SIP avseende delaktighet skall uppnås.Konklusion och praktiska implikationer. SIP tycks ha potential att bidra till en förbättrad samverkan om de professionella visar ömsesidig kollegial respekt och har fokus på barn och föräldrars behov. Detta kan lättare uppnås om professionella inte lägger för stor vikt vid skydda den egna verksamhetens agenda istället för en samverkansagenda. Detta bekräftas av delstudie 2 som visar att barn och föräldrar uppfattar att det finns intentioner att göra brukaren delaktig, men att denna intention hindras av oenighet, skilda intentioner och bristande samsyn mellan verksamheter, och barn och föräldrar får utstå förvirring och fragmentering av insatserna under lång tid, vilket kan utsätta barnet för risker. Om SIP skall bli det verktyg för helhetslösning och brukardelaktighet som det är avsett att vara, så behöver de berörda professionerna uppnå en bredare samsyn kring SIP för att uppfylla intentionen med en samverkan med utökad brukardelaktighet.
  •  
30.
  • Team i vård, behandling och omsorg : Erfarenheter och reflektioner
  • 2016. - 2
  • Samlingsverk (redaktörskap) (refereegranskat)abstract
    • Team är populära, inte minst inom vård, behandling och omsorg.Trots att det börjar bli en väl etablerad företeelse tycks teamfortfarande stå för förnyelse och nytänkande. Teamarbete harsåledes kommit att få en allt viktigare roll.I denna antologi behandlas frågor som: Varför uppstår team? Vadgör team nödvändiga? Vad är utmärkande för olika typer av team? Vad skapar väl fungerande team? Vilka effekter får teamarbete förverksamheten? Du som läsare bjuds på både kritiska betraktelser,utvecklingsspår och verktyg.Boken vänder sig till studerande och forskare vid högskolor ochuniversitet samt till praktiskt verksamma inom vård-, behandlingsochomsorgsorganisationer. De olika kapitlen kan läsas friståendeoch ger var för sig en god bild av teamets funktion.---Team i vård, behandling och omsorg förmedlar en unikinsikt och förståelse kring teamarbetes betydelse, funktionssätt och utmaningar baserad på omfattande och mångårig forskning. Boken förtjänar därför attanvändas inom alla utbildningar på högskolenivå som är inriktade mot vård- och omsorg.Stefan Tengblad, professor i företagsekonomi
  •  
31.
  • Berlin, Johan, 1975-, et al. (författare)
  • Cultural camouflage : a critical study of how artefacts are camouflaged and mental health policy subverted
  • 2015
  • Ingår i: International Journal of Health Planning and Management. - 0749-6753 .- 1099-1751. ; 30:2, s. 111-126
  • Tidskriftsartikel (refereegranskat)abstract
    • This study identifies hidden artefacts in a public organisation. In contrast to earlier studies, itfocuses on artefacts as concealing rather than conveying meaning. Negligent behaviour causedby an unpopular culture was recognised in five psychiatric wards at a Swedish universityhospital. Data comprising observations (87 h) and interviews (n = 60) were collected over aperiod of 48months (2008–2011). Four different items used in everyday work representing adeeper meaning of the organisation were identified during the observations. The items selectedwere work attire, nametags, keys and restraint beds. These were considered particularly promisingwhen it came to the aim of the study, namely, to find out how artefacts are camouflaged. Theobservations and the interviews revealed that these were controversial and contested artefacts inthe organisation. The study uses the term ‘cultural camouflage’ for behaviour that ignores andconsciously conceals symbols that have negative values. This concept contrasts with previousresearch that shows how artefacts are emphasised and how they contribute to the character ofthe activity in a transparent way. Conservative and backward-looking behaviour among staffprovided one explanation as to why artefacts were concealed. Another was the need to establishharmonious internal interactions.
  •  
32.
  • Berlin, Johan, 1975, et al. (författare)
  • Cultural Camouflage. A critical study of how artefacts are camouflaged and mental health policy subverted
  • 2015
  • Ingår i: International Journal of Health Planning and Management. - 0749-6753 .- 1099-1751. ; 30:2
  • Tidskriftsartikel (refereegranskat)abstract
    • This study identifies hidden artefacts in a public organisation. In contrast to earlier studies, it focuses on artefacts as concealing rather than conveying meaning. Negligent behaviour caused by an unpopular culture was recognised in five psychiatric wards at a Swedish university hospital. Data comprising observations (87 h) and interviews (n = 60) were collected over a period of 48 months (2008–2011). Four different items used in everyday work representing a deeper meaning of the organisation were identified during the observations. The items selected were work attire, nametags, keys and restraint beds. These were considered particularly promising when it came to the aim of the study, namely, to find out how artefacts are camouflaged. The observations and the interviews revealed that these were controversial and contested artefacts in the organisation. The study uses the term ‘cultural camouflage’ for behaviour that ignores and consciously conceals symbols that have negative values. This concept contrasts with previous research that shows how artefacts are emphasised and how they contribute to the character of the activity in a transparent way. Conservative and backward-looking behaviour among staff provided one explanation as to why artefacts were concealed. Another was the need to establish harmonious internal interactions.
  •  
33.
  • Berlin, Johan, 1975- (författare)
  • Doctors’ functional leadership inpsychiatric healthcare teams : a reversible leadership logic
  • 2015
  • Ingår i: Team Performance Management. - London. - 1352-7592 .- 1758-6860. ; 21:3/4, s. 159-180
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The purpose of this paper was to study how psychiatric doctors practise leadership in multidisciplinary healthcare teams. The paper seeks to answer the question: How do psychiatric doctors lead multidisciplinary teams during treatment conferences?Design/methodology/approach: Six psychiatric teams were studied at a university hospital. Each team was observed over a period of 18 months, and data were collected during four years (2008-2011). Data were collected through interviews with doctors (n19) and observations (n30) of doctors’ work in multidisciplinary psychiatric teams.Findings: Doctors in a multidisciplinary team use either self-imposed or involuntary leadership style. Oscillating between these two extremes was a strategy for handling the internal tensions of the team.Research limitations/implications: The study was a case study, performed during treatment conferences at psychiatric wards in a university hospital. This limitation means that there is cause for some caution in generalising the results.Practical implications: The results are useful for understanding leadership in multidisciplinary medical teams. By understanding the reversible logic of leadership, cooperation and knowledge sharing can be gained, which means that a situation of mere peaceful coexistence can be avoided. Understanding the importance of the informal contract makes it possible to switch leadership among team members. A reversible leadership with an informal contract makes the team less vulnerable. The team’s professionals can thus easily handle dif cult situations and internal tensions, facilitating leadership and management of multidisciplinary teams.Originality/value: Doctors in multidisciplinary psychiatric teams use reversible leadershiplogic.
  •  
34.
  • Berlin, Johan, 1975, et al. (författare)
  • Learning and Usefulness of Collaboration Exercises: A Study of The Three Level Collaboration (3LC) Exercises Between The Police, Ambulance, and Rescue Services
  • 2015
  • Ingår i: International Journal of Mass Emergencies and Disasters. - 0280-7270. ; 33:3, s. 428-467
  • Tidskriftsartikel (refereegranskat)abstract
    • In this article, we studied collaboration exercises (3LC) between the rescue services, ambulance services, and police force, which were developed to enhance learning and usefulness. The exercises’ structure was based on identified deficiencies in previous collaboration exercises. The purpose was to test the exercise model in terms of learning and usefulness. Ten 3LC exercises were observed. A total of 65 semi-structured interviews were conducted (2011–2014) in connection with the exercises. The exercises contained across-boundary elements, seminars, and interactive documentation. The participants were given the opportunity to discuss, analyze, and critically reflect on their efforts. During the seminars, the individual actions were analyzed, which led to alternative strategies that were subsequently tested in a repeated exercise. Our results demonstrate that repetitive features and seminars during collaboration exercises promote learning toward an organic behavior and usefulness in the actual incident work.
  •  
35.
  • Berlin, Johan, 1975-, et al. (författare)
  • Learning and usefulness of collaboration exercises : A study of the three level collaboration (3LC) exercises between the police, ambulance and rescue services
  • 2015
  • Ingår i: ; 33:3, s. 428-467
  • Tidskriftsartikel (refereegranskat)abstract
    • In this article, we studied collaboration exercises (3LC) between the rescue services, ambulance services, and police force, which were developed to enhance learning and usefulness. The exercises’ structure was based on identified deficiencies in previous collaboration exercises. The purpose was to test the exercise model in terms of learning and usefulness. Ten 3LC exercises were observed. A total of 65 semi-structured interviews were conducted (2011–2014) in connection with the exercises. The exercises contained across-boundary elements, seminars, and interactive documentation. The participants were given the opportunity to discuss, analyze, and critically reflect on their efforts. During the seminars, the individual actions were analyzed, which led to alternative strategies that were subsequently tested in a repeated exercise. Our results demonstrate that repetitive features and seminars during collaboration exercises promote learning toward an organic behavior and usefulness in the actual incident work.
  •  
36.
  • Berlin, Johan, 1975- (författare)
  • Ledarskap och beslutsfattande i psykiatriska team : om sammanhållning, sortering och kontroll
  • 2015. - 1
  • Bok (övrigt vetenskapligt)abstract
    • Den här studien handlar om ledarskap och beslutsfattande i psykiatriska team. För att hantera hälso- och sjukvårdens gränsöverskridande arbete har teamarbete använts som arbetsform.Det övergripande syftet med studien har varit att studera hur ledarskap och beslutsfattande tillämpas i psykiatriska team. De frågor som behandlas är; att beskriva och skapa förståelse för hur ledarskap i psykiatriska team tillämpas, att beskriva och skapa förståelse för hur beslutsfattande i psykiatriska team tillämpas, att förklara varför eventuella skillnader finns mellan prat och praktik, samt att förklara varför teamarbete tillämpas i psykiatrin.Studiens teoretiska referensram utgår ifrån de utmaningar som uppstår när teamarbete ska organiseras i en multiprofessionell kontext. I studien tas beslutsteori, ledarskapsteori och nyinstitutionell teori till hjälp för att länka ihop och ge förklaringar till professionernas handlingsmönster.Studiens data har samlats in 2008-2011 genom intervjuer, observationer och dokumentstudier. Totalt består studien av 101 intervjuer med 111 informanter. Observationer har gjorts i 10 team vid 132 tillfällen under totalt 230 timmar. Vid observationerna har fokus varit på det teamarbete som utförts vid behandlingskonferenser.Studien visar: 1) att det finns ett informellt kontrakt i teamen som styr vem som gör vad i olika situationer, 2) att läkarna tillämpade ett reversibelt ledarskap som gjorde att de växlade mellan det ofrivilliga och det självpåtagna, 3) att teamen använde beslutsnormer som styrdes av situationsspecifika mikrokoder, 4) att det fanns en episodisk kultur som minskade drivkraften att ge en förebyggande och långsiktig behandling, 5) att teamarbete användes för att ge möjlighet till sammanhållning, sortering och kontroll samt 6) att det inte fanns någon strävan efter perfektion i beslutsfattandet, istället nöjde sig teamen med en acceptabel nivå som alla kunde enas om.
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37.
  • Berlin, Johan M, 1975-, et al. (författare)
  • Collaboration exercices; what do they contribute? : a study of learning and usefulness
  • 2015
  • Ingår i: Journal of Contingencies and Crisis Management. - 0966-0879 .- 1468-5973. ; 23:1, s. 11-23
  • Tidskriftsartikel (refereegranskat)abstract
    • This article aims to study whether exercises contribute to learning that can be useful in actual emergency work. It reports the findings of a study about professional emergency personnel’s perceptions of the impact of collaboration exercises. Surveys were distributed and collected from emergency personnel in conjunction with three collaboration exercises that took place in Sweden in spring 2012. The survey included personnel holding different positions within the police department, fire department and ambulance services. Among them were also operational personnel such as officers. A total of 94 professional emergency personnel agreed to participate by answering the survey. The response rate was 95%.The study shows that collaborative elements in exercises contribute to perceived learning (R2 = 0:53), and that learning, in turn, has a perceived beneficial effect on actual emergency work (R2 = 0:26).The perceived results of collaboration,learning and their impact on actual emergency work, however, are moderate.The exercises were characterised by long waiting times and gave few opportunities to practise different strategies. Only a few respondents felt that they learned something about the collaborating organisations’ ways of communicating and prioritising. Many also thought that the exercises were more useful for command officers than for operational personnel.Thus, the study shows that by strengthening the collaborative elements of the exercises, the perception of the participants’ actual emergency work can be developed.
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38.
  • Berlin, Johan, 1975-, et al. (författare)
  • Samverkansövningar : Om lärande och nytta
  • 2015. - 1
  • Bok (övrigt vetenskapligt)abstract
    • Den här studien handlar om samverkansövningar med särskilt fokus på fullskaleövningar mellan polis, räddningstjänst och ambulans. För att lyckas i en komplex situation behöver personalens förmåga att samverka organisationsövergripande utvecklas och förfinas.Det övergripande syftet med denna studie var att studera hur samverkan övas och hur övningarna leder till lärande och nytta. I studien gjordes inledningsvis en forskningsöversikt. Utifrån den har ett antal centrala begrepp tagits fram som varit till hjälp när vi följt svenska samverkansövningar genom intervjuer och observationer. Den samlade analysen har sedan legat till grund för konstruktionen av en ny övningsmodell, 3NS, trenivåsamverkan. Den bygger på erfarenheter vi gjort i studier av traditionella övningar.De 3NS-övningar som genomfördes bestod av två praktiska moment och tre seminarier. Varje moment följdes av ett utvärderande seminarium som syftade till att deltagarna själva skulle reflektera och utveckla sitt handlingsmönster. De båda praktiska momenten var identiska. Det gav de övande tillfälle att repetera och metodiskt prova nya angreppssätt. Det första övningsmomentet genomfördes enligt de rutiner som normalt tillämpas och styr handlandet vid en skarp händelse. Det andra övningsmomentet föregicks av ett självkritiskt seminarium där deltagarna själva identifierade vad som kunde förbättras till nästa övningsomgång.Forskningsprojektet har genomförts 2011-2014. Totalt har 19 samverkansövningar studerats, varav 16 fullskaleövningar. I studien har totalt 97 intervjuer och 125 timmar observation genomförts. En enkät (CLU-instrument) har utvecklats, vilken besvarats av 272 övningsdeltagare.Studien visar att kollaborativa moment vid övningar bidrar till att deltagarna lär sig mer och har större nytta av övningar. 3NS-övningarna uppfattades förbättra lärandet med 26 procent och nyttan med 17 procent jämfört med traditionella övningar. Samverkansövningar gynnas av att de övande själva analyserar sina svagheter. Repetitiva inslag där de övande prövar alternativa strategier förbättrar beredskapen inför skarpa händelser.
  •  
39.
  • Berlin, Johan, 1975, et al. (författare)
  • Samverkansövningar – Om lärande och nytta
  • 2015
  • Bok (övrigt vetenskapligt)abstract
    • Den här boken handlar om samverkansövningar mellan blåljusorganisationer. Det övergripande syftet med studien är att studera hur samverkan övas och hur övningarna leder till lärande och nytta. I studien testas en ny övningsmodell, trenivåsamverkan (3NS), som bygger på erfarenheter från traditionella samverkansövningar. Den nya övningsmodellen innehåller fler kollaborativa moment, seminarier och repetition. Data har samlats in genom observationer, intervjuer, dokument och enkäter från totalt 19 svenska samverkansövningar (2011–2014). Studien visar att 3NS-övningarna uppfattas ge mer lärande och nytta jämfört med traditionella samverkansövningar. I övningarna får de övande själva möjlighet att analysera sina svagheter och i repetitiva moment pröva olika strategier. I boken får läsaren exklusiva inblickar som kan vara till stor nytta, i synnerhet om det finns en ambition att utveckla ett mer gränsöverskridande arbete på skadeplats. Övningsmodellen (3NS) är unik eftersom den är vetenskapligt validerad. Boken riktar sig till alla som är intresserade av samverkansövningar. Den kan med fördel läsas av övningsledare som står inför utmaningen att utveckla sin kommande samverkansövning. Även forskare, politiker och tjänstemän har sannolikt stor behållning av boken.
  •  
40.
  • Berlin, Johan, 1975-, et al. (författare)
  • The Three-Level Collaboration Exercise : Impact of Learning and Usefulness
  • 2015
  • Ingår i: Journal of Contingencies and Crisis Management. - 0966-0879 .- 1468-5973. ; 23:4, s. 257-265
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the study was to examine the emergency personnel’s perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other’s tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasi-experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).
  •  
41.
  • Berlin, Johan, 1975, et al. (författare)
  • The three level collaboration exercise – impact of learning and usefulness.
  • 2015
  • Ingår i: Journal of Contingencies and Crisis Management. - 0966-0879 .- 1468-5973. ; 23:4
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2015 John Wiley & Sons Ltd. The aim of the study was to examine the emergency personnel's perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other's tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasiexperimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).
  •  
42.
  • Alverbratt, Catrin, et al. (författare)
  • The process of implementing a new working method - a project towards change in a Swedish psychiatric clinic
  • 2014
  • Ingår i: Journal of Hospital Administration. - 1927-6990 .- 1927-7008. ; 3:6, s. 174-189
  • Tidskriftsartikel (refereegranskat)abstract
    • The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.
  •  
43.
  • Andersson, Annika, 1981-, et al. (författare)
  • Managing boundaries at the accident scene : a qualitative study of collaboration exercises
  • 2014
  • Ingår i: International Journal of Emergency Services. - : Emerald Group Publishing Ltd. United Kingdom. - 2047-0894 .- 2047-0908. ; 3:1, s. 77-94
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.Design/methodology/approach Interviews with 23 participants from four exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis.Findings Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision-making.Originality/value The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.
  •  
44.
  •  
45.
  •  
46.
  • Berlin, Johan, 1975-, et al. (författare)
  • Collaboration Exercises : the lack of collaborative benefits
  • 2014
  • Ingår i: International Journal of Disaster Risk Science. - 2095-0055. ; 5:3, s. 192-205
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this paper is to study what professional emergency personnel learn during collaboration exercises and the benefits of what they have learned. Observations (n=19) and semistructured interviews (n=32) were carried out in conjunction with major exercises held in Sweden (2007–2012). The results show that exercises tend to be based on its own logic, which differs from actual events. Exercise participants believe that they mainly learn single-track, parallel and path-dependent behavior. The exercises do not facilitate the use of cross-boundary activities. This means that learning as well as benefits of the exercises for actual events is limited. The exercises would be more appropriate if those participating had the opportunity to identify weaknesses, try alternative ways as well as had the opportunity to have comprehensive organizational analyses at the conclusion of the exercises. Based on the results of the study, alternative models for the exercises are suggested that contain elements, which develop collaboration and contribute to learning.
  •  
47.
  • Berlin, Johan, 1975, et al. (författare)
  • Collaboration Exercises – The Lack of Collaborative Benefits
  • 2014
  • Ingår i: International Journal of Disaster Risk Science. - 2095-0055 .- 2192-6395. ; 5:3, s. 192-205
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this article is to analyze what professional emergency personnel learn during collaboration exercises and the benefits of what they have learned. Observations (n = 19) and semistructured interviews (n = 32) were carried out in conjunction with major exercises held in Sweden (2007–2012). The results show that exercises tend to be based on their own logic, which differs from actual events. Exercise participants believe that they mainly learn single-track, parallel, and path-dependent behavior. The exercises do not facilitate the use of cross-boundary activities. This means that learning, as well as benefits from the exercises for actual events, is limited. The exercises would be more appropriate if those participating had the opportunity to identify weaknesses, try alternative ways, and engage in comprehensive organizational analyses at the conclusion of the exercises. Based on the results of the study, alternative models for collaboration exercises are suggested, with elements that would better develop collaboration and contribute to learning.
  •  
48.
  • Berlin, Johan, 1975- (författare)
  • Common incentives for teamwork : the unspoken contract´s significance
  • 2014
  • Ingår i: Team Performance Management. - 1352-7592 .- 1758-6860. ; 20:1/2, s. 65-80
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose - The purpose of this article was to identify and study common incentives for teamwork.Design/methodology/approach - The study was designed as a case study. The case consists of teamwork at a univer-sity hospital. At the hospital, ten psychiatric teams were studied for a period of four years (2008-2011). Each team was followed for 12–18 months. Data were collected through interviews (n = 48) and observations (n = 52) of the teamwork at treatment conferences.Findings - The common incentives identified consist of shared responsibility, appreciation and long-sightedness. The incidence of a silent contract is highlighted as an explanation for the team's cohesion.Research limitations/implications - The study is conducted in a public organisation within one field. The results should therefore be interpreted with some caution.Practical implications - The study is useful for practitioners to understand the importance of common incentives as a collective driving force. By developing well-adapted common incentives, the practical work can be developed, refined and improved.Originality/value - The significance of common incentives and the unspoken contract in the team is identified.
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49.
  • Berlin, Johan, 1975- (författare)
  • How doctors practice teamleadership
  • 2014
  • Konferensbidrag (refereegranskat)abstract
    • Purpose: The overall purpose of the article was to study how doctors practise leadership in multidisciplinary teams. The article seeks to answer the question: Which approach do doctors use to lead multidisciplinary psychiatric teams?Methodology: Six psychiatric teams were studied at a university hospital. Each team was followed for eighteen months. Data were collected during a period of four years (2008–2011). Data were collected through interviews with doctors (n = 19) and observations (n = 30) of doctors’ work in a multidisciplinary psychiatric team.Findings: Doctors in a multidisciplinary team use either self-imposed or involuntary leadership. Oscillating between these two extremes is called reversible leadership.Research limitations: The study was performed at a psychiatric ward during treatment conferences in a university hospital. This limitation means that there is cause for some caution in interpreting the results.Practical implications: The results are useful for understanding leadership in multidisciplinary teams within the health and medical care system. The reversible leadership means that doctors can more easily oscillate from difficult situations and deal with internal tensions, facilitating leadership and management of the multidisciplinary team in the intended direction.Originality / value: Doctors in multidisciplinary psychiatric teams use reversible leadership.
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50.
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