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- Böling, Susanna, et al.
(författare)
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No ordinary consultation : a qualitative inquiry of hospital palliative care consultation services
- 2020
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Ingår i: Journal of Health Organization and Management. - : Emerald Group Publishing Limited. - 1477-7266. ; 34:6, s. 621-638
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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. |
- Carlström, Eric, 1957, et al.
(författare)
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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
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 12:14
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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 emergency staffs' perceptions of the impact of exercises. The data were retrieved from surveys conducted by the 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 professional emergency personnel participated in the ONSO exercises and 252 in the OFFSO exercises. The study was based on the suggestion that collaborative elements during an inter-organisational exercise promote learning, and learning is important to make the exercises useful. Collaboration proved to be a predictor for some of the items in learning, and learning was a predictor for some of the items in utility. There was, however, a stronger covariation between collaboration, learning and utility in the OFFSOs exercises than in the ONSOs. One reason might be the different cultures of emergency staff involved in on-shore and off-shore organisations. The OFFSOs' qualifications may be dominated by seamanship, 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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| 3. |
- Hernborg, Martin N., et al.
(författare)
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First initiatives in prehospital care : Basing assessments on incomplete preliminary information
- 2020
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 0:6, s. 47-54
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)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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| 4. |
- Jansson, Magnus, et al.
(författare)
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Drivers of outsourcing and backsourcing in the public sector : From idealism to pragmatism
- 2020
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Ingår i: Financial Accountability and Management. - : John Wiley & Sons. - 0267-4424 .- 1468-0408. ; 37:3, s. 262-278
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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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| 5. |
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| 6. |
- Nord-Ljungquist, Helena
(författare)
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Vem har och tar ansvar! : – I Väntan På Ambulans (IVPA)-uppdrag i Glesbygdsmiljö
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)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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| 7. |
- Raidla, Annelie, et al.
(författare)
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Outcomes of Establishing an Urgent Care Centre in the Same Location as an Emergency Department
- 2020
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Ingår i: Sustainability. - : MPDI. - 2071-1050. ; 12:19
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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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