| 1. |
- Dellve, Lotta, et al.
(författare)
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Lean implementation approaches at different levels in Swedish hospitals : the impor¬tance for working conditions, worker engagement, health and performance.
- 2014
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Konferensbidrag (refereegranskat)abstract
- This paper reports result from one-year follow up in a research program with the overall aim to investigate how implementations of lean in health care affect working conditions, health, and performance of employees at five Swedish hospitals. This paper summarizes the implementation approaches, and their importance at short-term follow up for performance (with regard to active work with improvements), perceived working conditions and stress-related health among the healthcare workers. The implementation strategies and pace varied between the hospitals and between the strategic and operative levels. This short-term follow up showed that physical stress-related symptoms had increased overall but the cognitive stress had increased only in hospitals implementing lean. In hospitals with high implementation pace, there were more improvement work among the employees, but higher quantitative demands and lower job satisfaction.
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| 2. |
- Dellve, Lotta, 1965-, et al.
(författare)
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The impact of implementation of lean at hospitals for work conditions and health-related conditions among health care professionals: a three year follow-up
- 2015
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Konferensbidrag (refereegranskat)abstract
- Introduction The public sector has during the last decades been struggling with the challenge of how to increase the efficiency, the quality of performance, as well as with problems related to work environment and recruitments. Hospitals have struggled with increased focuses on costumer orientation, rationalizations and care processes redesign, and have often used Lean production (LP) as management model.Aim to assess the long-term importance of implementing LP in hospitals for the psychosocial work conditions. Based on earlier research (e.g. Westgaard & Winkel, 2011), the following hypothesis were tested (1) Strategic large scale implementation of LP is associated with negative impact on mental health; (2) Implementation of LP is associated with weak negative impact on psychosocial work conditions; (3) The association between implementation of LP and psychosocial conditions is moderated by profession and participatory approaches.Method Five hospitals working with improvements of care processes were studied 2012-2014 using questionnaires to employees (T1 n=1303) and interviews at strategic and operative levels. Analyzes with mixed models repeated measurements were performed. The explaining variables for the models were implementation of lean at strategic resp operative level, and time (T1, T2, T3). The outcome variables were work-related health (SRH, work ability, stress-symptoms) and psychosocial work conditions.Results Physical, cognitive and mental stress-related symptoms were only weakly associated with strategic or operative LP initiatives. There were no overall differences in self rated health and work ability with regard to implementation of LP. A higher degree of LP at operative level was associated with decreased work demands. There was, especially initially, more beneficial or improved working conditions in relation to higher degree of LP at operative levels. The long-term follow-up showed that quantitative demands increased and predictability as well as leadership decreased in the non-lean hospitals. There were different patterns with regard to profession and participatory approaches that will be presented.
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| 3. |
- Gellerstedt, Martin, 1966-, et al.
(författare)
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Does sex influence the allocation of life support level by dispatchers in acute chest pain?
- 2010
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Ingår i: The American journal of emergency medicine. - Philadelphia, PA : Elsevier BV. - 1532-8171 .- 0735-6757. ; 28:8, s. 922-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate (a) the differences between men and women in symptom profile, allocated life support level (LSL), and presence of acute myocardial infarction (AMI), life-threatening condition (LTC), or death and (b) whether a computer-based decision support system could improve the allocation of LSL.
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| 4. |
- Holden, Richard, et al.
(författare)
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Healthcare workers' perceptions of lean : A context-sensitive, mixed methods study in three Swedish hospitals
- 2015
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Ingår i: Applied Ergonomics. - : Pergamon Press. - 0003-6870 .- 1872-9126. ; 47, s. 181-192
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Tidskriftsartikel (refereegranskat)abstract
- As the application of lean in healthcare expands, further research is needed in at least two areas: first, on the role of context in shaping lean and its consequences and second, on how healthcare workers perceive lean. Accordingly, this context-sensitive, mixed methods study addressed how hospital workers' perceptions of lean varied across contexts in three Swedish hospitals. Registered nurses and physicians at the hospitals and across units differing in acuity completed standardized surveys (N = 236, 57% response rate) about their perceptions of hospital-wide lean implementation. Perceptions varied by: hospital context, with one hospital's employees reporting the least favorable perceptions; unit acuity, with higher-acuity units reporting more favorable perceptions; and professional role, with nurses reporting more favorable perceptions than physicians. Individual interviews, group interviews, and observations provided insight about these dissimilar contexts and possible explanations for context-specific variability. Findings are discussed with respect to strategies for implementing lean in healthcare; the importance of attending to levels, context, and worker consequences of lean; and directions for future research.
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