| 1. |
- Cregård, Anna, 1971, et al.
(författare)
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Medicinare som managers
- 2011
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Ingår i: School of Business, Nordic Academy of Management (NFF) conference, 20-24 august, 2011.
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Konferensbidrag (refereegranskat)abstract
- Sjukvårdspersonalen har ett stort inflytande på sitt arbete. I en tid när NPM fått en stark inverkan på offentliga organisationer förskjuts det som tidigare varit den offentliga sektorns kännetecken som: demokrati, öppenhet, yttrandefrihet, samverkan, helhetssyn och rättssäkerhet, till mer ekonomistiska och managementlika sådana, som produktivitet, kostnadseffektivitet, kundorientering, resultatkrav och avtal. Syftet i denna artikel är att kritiskt diskutera tillsättningen av medicinare på traditionella manage-menttjänster i hälso- och sjukvården och vad det kan medföra. Dessa tillsättningar motiveras vanligen av förbättrad effektivitet, men också av kvalitet och säkerhet för verksamheten. Skälen är svåra att argumentera emot, och därför har de fått stark genomslagskraft. Vi vill just peka på riskerna, som ofta negligeras och förespråkarna har en slagkraftig retorik. Positiva effekter saknas inte men de måste vägas mot de negativa effekterna. Metoden är intervjuer med 15 sjuksköterskor och läkare som har chefsuppdrag. Därtill har vi 5 fokusgrupper som består av verksamhetsansvariga sjuksköterskor och läkare under managementutbildning. Resultaten visar på att det främst är fyra risker förknippat med tillsättning av medicinare på tradit-ionella managementtjänster: läkarens professionella kompetens minskar, förtroendet för läkaren som medicinsk kunnig minskar, liksom för organisationen och vården i stort. Därtill trängs viktiga värden inom servicedomänen undan till förmån för administrativa värden.
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| 2. |
- Eriksson, Nomie, 1955-
(författare)
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Organizing for Development Work in Healthcare Organizations : A study of Quality Methods for Reliable Care
- 2015
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Ingår i: 23rd Nordic Academy of Management Conference. ; , s. 138-138
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Konferensbidrag (refereegranskat)abstract
- Healthcare professionals are involved in development work that is always present in healthcare organisations. They are required to participate when quality methods such as Lean and Six Sigma are introduced in hospitals’ clinical practises. The purpose of this paper is to explore how development work in terms of providing reliable care are perceived by nurses and physicians when quality methods are implemented in clinical practises. The data consist from in-depth, semi-structured interviews with seventeen nurses and ten physicians at two hospitals in western Sweden. A qualitative research method was used. The interviews were analysed in the search for underlying themes that reflect their perception and evaluation of the quality methods and their possibility to increase the reliability in healthcare. The confidence between nurses and physicians was essential for creating and maintaining supportive relationships and reliable systems. Reliable care seemed to be more of the result of the dedication and professionalism than the result of the applied quality methods. Reliability in healthcare seemed to flow from work attitudes, commitment and continuous development work as much as from quality methods. In general, the professionals more emphasized the importance of teamwork and cooperation as ways to develop healthcare.
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| 3. |
- Söderström, Eva, 1972-, et al.
(författare)
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A Holistic Approach of how to handle Patient Information to support Seamless and Secure care
- 2021
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Ingår i: Proceedings of the 7th International Workshop on Socio-Technical Perspective in IS Development (STPIS 2021). - : CEUR-WS. ; , s. 198-203
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Konferensbidrag (refereegranskat)abstract
- Healthcare, like society in general, is facing great changes and challenges. Rapid development and uptake of digital technologies bring about the need to change. With the COVID-19 pandemic, the amount of healthcare meetings taking place online has surged. This means, among other things, that there are more healthcare actors involved in a patient’s care, and that information relating to a patient needs to be shared across borders now more than ever need to be improved. However, this is currently not done seamlessly, and there are many hinders and obstacles to overcome. This research aims at enabling a holistic approach on how to handle patient information in order to support seamless and secure care along the whole patient process. In doing so, drivers and hinders need to be identified, and a socio-technical framework with concrete guidelines will be developed. These results will be a first step towards filling this research gap, and will connect several perspectives in order to make the results truly actionable and holistic.
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| 4. |
- Söderström, Eva, et al.
(författare)
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Standardisation as a Means to Improve Information Security in Process-Oriented Distributed Healthcare
- 2008
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Ingår i: Proceedings (ed) Kai Jacobs and Eva Söderström. Presented at the 13 th European Academy for Standardization (EURAS), 2008-06-16-17, Skövde Sweden.. - Aachen : Mainz. - 1437-8396. - 3861308096 ; 2008:ABI Band 40, s. 233-243
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Konferensbidrag (refereegranskat)abstract
- Regardless of who we are, where we are, and when we get sick, we expect the healthcare sectors to take care of us. And we expect it to treat us with respect. Not the least, this concerns treating our personal information with care. However, the reality is that most healthcare institutions work separately, and that the flow of patient information therefore is less than optimal. This paper aims to investigate how current standards map against the concept of information security, and how process-orientation can be used in conjunction with standards to create secure information flows in healthcare. It does so by describing information security and process-orientation, and investigates how standards for information security apply in a process-oriented, distributed healthcare sector. The result shows that a dual focus is needed, on document and process standardisation, and that healthcare is facing great challenges in order to make this work.
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| 5. |
- Söderström, Eva, et al.
(författare)
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Trusting digitized patient-related information: The need for a new approach
- 2011
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Ingår i: In Furnell and Clarke (eds.), Proceedings of the 5th International Symposium on Human Aspects of Information Security and Assurance (HAISA), London, 2011. - : Plymouth Center for Security, Comunications & Network Research, University of Plymouth. - 9781841022840 ; , s. 119-129
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Konferensbidrag (refereegranskat)abstract
- Trust is receiving increasing attention nowadays, particularly since new technology enables communication and collaboration like it has never been seen before. However, trust is a fuzzy concept that needs further examination and attention from multiple levels. For example, security is very important from a user’s point of view in trusting that technology will function in accordance with the user’s intended and requested function. This paper reviews the concept of patient safety, which thus far has been discussed and defined from a narrow technical perspective. We demonstrate that it is much more complex, and that it is not primarily the technical issues that are problematic, but rather the cultural, process-related and personnel issues. Our results point to a need for a new approach, which takes the patients’ view of healthcare and the patient-related digital information as its focus. The discussion is made from a Swedish perspective, but the issues are international. The needs for information and knowledge in healthcare are obvious. Without clear definitions of concepts and roles, a good information flow or process cannot be designed. Our discussion shows that trusted digital patient information gives an opportunity for a patient-focused healthcare. Multidimensional trust must be addressed on all levels; organization, person and technology. More empirical research into trust in digital patient-related information is necessary, to develop a model for patient safety from a trust perspective that encompasses all levels of trust.
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| 6. |
- Eriksson, Nomie, 1955-
(författare)
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Maintaining Healthcare Organizations’ Reliability in Times of Change
- 2014
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Ingår i: British Academy of Management 2014. - London. - 9780954960872 ; , s. 1-18
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Konferensbidrag (refereegranskat)abstract
- Healthcare organizations should be reliable and resilient when unexpected events occur that create pressure for change. This paper discusses the importance of reliability and resilience when a decision is made to standardize the professionals’ work methods.The aim was to explain how healthcare organizations can maintain high reliability in the operations beyond an unexpected event.Two qualitative case studies at two hospitals are used to compare the work methods. Semi-structured interviews and follow-up questions were conducted with managers, nurses, and physicians in departments of cardiology and urology. Annual reports and operation plans also provide data. High reliability healthcare organization is sufficiently resilient in times of change if providing quality care, encourages flexibility, individual responsibility, promotes good communication, develops learning processes and gives legitimacy. Professionals need participate in decision-making processes and require time and opportunity to develop knowledge and skills.
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| 7. |
- Eriksson, Nomie, 1955-
(författare)
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Nurses’ perceptions of healthcare development work in a high reliability organisation : A study of Lean and Six Sigma in hospital management
- 2015
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Ingår i: BAM2015. The Value of Pluralism in Advancing Management research, Education and Practice. - London. - 9780954960889 ; , s. 1-17
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Konferensbidrag (refereegranskat)abstract
- Most nurses are deeply involved in healthcare development work. Nurses are required to participate as they coordinate processes with other health professionals in the entire hospital care chain.To investigate how nurses perceive and evaluate healthcare development work when Lean and Six Sigma are introduced in clinical practises, in-depth, semi-structured interviews with seventeen nurses at two hospitals were used.The nurses mean that quality healthcare is more dependent on hospital personnel than on the use of Lean and Six Sigma. Lean can be used in some healthcare areas but not in all. Six Sigma can be used only if some precautions are taken and personnel participate in the decision-making. Furthermore nurses do stress the importance of education and training, teamwork, and cooperation as ways to improve healthcare.
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| 8. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Easier to trust managers than management? : The case of improvement work in healthcare
- 2011
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Konferensbidrag (refereegranskat)abstract
- Previously, improvement work in healthcare has mainly been medically related and driven by medical research, but NPM implies that management-initiated improvement work targeting organizing, productivity, efficiency, work flow etc. has become more and more common. Management-initiated improvement work has a high failure rate, and in general it seems difficult to motivate co-workers to actively participate. In all processes of organizational change, trust in the initiator of a change project is an important prerequisite to enable change take place. In this article, our purpose is to investigate how trust in management influences management-initiated improvement work. In a qualitative study we investigate improvement work at three Swedish hospitals. Our theoretical framework is based on a view of management as being both the people who manage and the system of management. This distinction is important since we can trust people and we can have confidence in a system, but these processes are different. Consequently, it is possible to trust individual managers, but as long as we do not trust management as a system, management-initiated improvement work will face considerable problems. To analyze trust we use a model that identifies three important antecedents for one person (the trustor) to consider another person (the trustee) as trustworthy: ability, benevolence and integrity. Using social system theory, we extend this model to on the one hand describe trust in specific persons (specific managers), and on the other hand describe confidence in a system (management in general, which the system-specific managers are parts of). The results indicate that there in general is a lack of trust between healthcare personnel and healthcare management. We were able to find certain managers who were found trustworthy by the personnel, but despite these trust-relations the personnel did still not have confidence in management as a system. To the contrary, these managers were perceived as exceptions, and did not change the perception of management in general. The consequences for management-initiated improvement work were that most personnel at best were ignorant to it, and at worst resisted it openly. However, there were examples when trusted enthusiastic managers succeeded in initiating improvement work, but then the continuation and success was directly connected to this person, and if s/he left, the improvement work stopped. Furthermore, some work groups seemed to very clearly separate “real” improvement work, which they initiated themselves, from “phony” improvement work initiated by management, which only stole time from more important tasks.
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| 9. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Organisering av förbättringsarbete inom vården med inspiration från industrin
- 2011
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Konferensbidrag (refereegranskat)abstract
- I denna artikel fokuserar vi på användandet av industriellt baserade produktionssynsätt (IBP) inom vården i avsikt att arbeta systematiskt med förbättringsarbete. Tidigare forskning har visat att det är svårt att få nya arbetsmetoder att få genomslag i den dagliga praktiken. I denna artikel fokuserar vi på om det går att se indirekta effekter såsom hur förbättringsarbetet organiseras beroende på vilka IBP olika sjukhus väljer att arbeta med. Undersökning är genomförd genom fallstudier på tre sjukhus som har valt att arbeta med tre olika metoder: six sigma, processorientering och mikrosystem.Studien visar att de olika logikerna bakom de olika metoderna ger fundamentalt olika sätt att organisera förbättringsarbetet vid de tre sjukhusen. Six sigma-sjukhuset valde ett centraliserat förbättringsarbete i hög grad drivet av experter på förbättringsmetoder, processsjukhusethade en expertavdelning som var mer av bollplank och utbildare för verksamhetens förbättringsarbete och mikrosystem-sjukhuset valde ett decentraliserat förbättringsarbete där förbättringsarbetet var både lokalt initierat och drivet.
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| 10. |
- Eriksson, Nomie, 1955-
(författare)
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Challenges in Hospitals Digitalization – Physicians’ and Nurses’ Outlook
- 2017
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Konferensbidrag (refereegranskat)abstract
- Digitalization is sweeping every organization. Also in hospitals patients’ records go through a digitization process to become electronic healthcare record, (EHR).Purpose – This study describe physicians and nurses perceptions towards digitization of their work practices. The overall questions is: What are the professionals’ perceptions on how to work with digitalized information systems?Design/methodology/approach –The sample consisted of physicians (n=64) and nurses (n=261) working in a Swedish regional hospital. A standardized questionnaire was coupled with free-text options as well. The professionals’ perceptions of EHR were compared with the traditional paper-based records.Findings – The professionals reacted with resistance and need more time and more well-developed systems to exercise their new skills. Competence to document in itself is not the problem. The problem is how to perform their new EHR work in daily practise. Communication problems between different systems become obvious. The study shows that performability is important when working with digitization in every day’s practises.Practical implications – There are still shortcomings in the quality of the documentation in EHR. Redundant documentations have to be minimized. The communication between systems and information to patient have to be developed. It also important to have more and better work places for professionals’ possibility to perform their skills. Additionally, to increase their knowledge of digitization in healthcare the professionals need continuous training and time to discuss pros and cons with the digitization.
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