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- Avby, Gunilla, 1965-, et al.
(författare)
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Samarbete bygger en stark primärvård
- 2017
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Ingår i: Dagens Nyheter 2017-08-17. - Stockholm : Dagens Nyheter. - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 4. |
- Höög, Elisabet, et al.
(författare)
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Developing an organizational change facilitating agency’s approach to system-wide development in health and social care
- 2013
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Konferensbidrag (refereegranskat)abstract
- PurposeThe important role of change agents as facilitators of organizational development processes is well recognized. Change interventions can address several levels: individuals, group/units or organizational systems. To facilitate system wide changes in complex health and social service organizations multiple facilitation approaches are needed. The purpose of this study was to examine an organizational change facilitating agency (OCFA) acquiring a new system wide facilitation approach.Design/MethodologyThe case study focuses on a regional support unit in Swedish health and social care, centered on care of the elderly and functionally impaired. Interviews, surveys, process diaries and observations of meetings provided data for qualitative content analyses.ResultsRespondents described a rocky journey and a learning loop providing insights on how to support development and learning for actors on multiple organizational levels. The OCFA learning process included meta levels of reflection and parallel work with organizational pilot cases. Respondents reported enhanced analytical and problem solving skills and the previously vague OCFA role was clarified and expanded. During the studied period the OCFA group clarified and enlarged their mission and organizational role in communication with stakeholders.LimitationsTo fully understand the potential of OCFA and system wide facilitation approaches further investigations are needed.Research/Practical ImplicationsOrganizational development requires adequate change process support. How to attain such support is less known. The provided description of a support function acquiring a system-wide facilitation approach can aid future development of the OCFA function.Originality/ValueThis study contributes to the knowledge on how to develop the approaches used by an OCFA to facilitate system-wide organizational development.
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| 6. |
- Kjellström, Sofia, 1970-, et al.
(författare)
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Leadership as a driver for work motivation : a study of well-functioning primary healthcare centers in Sweden
- 2017
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Konferensbidrag (refereegranskat)abstract
- Introduction: Little is known about how, why, or under which circumstances work motivation is formed and linked to reforms and interventions.Aim: The aim of this study is to explore work motivation among professionals at well-functioning primary healthcare centers subject to a national healthcare reform which include financial incentives.Material & method: Five primary healthcare centers in Sweden were purposively selected for being well-operated and representing public/private and small/large units. Forty-three interviews were completed with different medical professions and qualitative deductive content analysis was conducted.Results: Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers’ positive management was due to a unique combination of factors, such as clear direction of goals, a culture of nonhierarchical collaboration, and systematic quality improvement work. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created. The units expressed a collective capacity to produce direction, alignment and commitment.Conclusions: The design of the reforms and leadership are essential preconditions for work motivation. Leaders need to consistently translate and integrate reforms with the professionals’ drives and values. This is done by encouraging participation through teamwork, time for structured reflection and quality improvement work. The values of the study consist of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms, and how professionals collectively produce leadership.
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| 7. |
- Kjellström, Sofia, 1970-, et al.
(författare)
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Work motivation among healthcare professionals: A study of well-functioning primary healthcare centers in Sweden.
- 2017
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Ingår i: Journal of Health Organization and Management [1477-7266]. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 31:4, s. 487-502
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Purpose – The purpose of this paper is to explore work motivation among professionals at well-functioningprimary healthcare centers subject to a national healthcare reform which include financial incentives. Design/methodology/approach – Five primary healthcare centers in Sweden were purposively selectedfor being well-operated and representing public/private and small/large units. In total, 43 interviews werecompleted with different medical professions and qualitative deductive content analysis was conducted. Findings – Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers’ positive management was due to a unique combination of factors, such as clear direction of goals, a culture of non-hierarchical collaboration, and systematicquality improvement work. The financial incentives need to be translated in terms of quality patient care to provide clear direction for the professionals. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created. Practical implications – Leaders need to consistently translate and integrate reforms with the professionals’ drives and values. This is done by encouraging participation through teamwork, time for structured reflection, and quality improvement work. Social implications – The design of the reforms and leadership are essential preconditions for work motivation. Originality/value – The study offers a more complete picture of how reforms are managed at primary healthcare centers, as different medical professionals are included. The value also consists of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms.
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| 8. |
- Nyström, Monica E., et al.
(författare)
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Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region
- 2018
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Ingår i: BMC Health Serv Res. - : Springer Science and Business Media LLC. - 1472-6963. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Eldercare and care of people with functional impairments is organized by the municipalities in Sweden. Improving care in these areas is complex, with multiple stakeholders and organizations. Appropriate strategies to develop capability for continuing organizational improvement and learning (COIL) are needed. The purpose of our study was to develop and pilot-test a flexible, multilevel approach for COIL capability building and to identify what it takes to achieve changes in key actors' approaches to COIL. The approach, named "Sustainable Improvement and Development through Strategic and Systematic Approaches" (SIDSSA), was applied through an action-research and action-learning intervention. Methods: The SIDSSA approach was tested in a regional research and development (R&D) unit, and in two municipalities handling care of the elderly and people with functional impairments. Our approach included a multilevel strategy, development loops of five flexible phases, and an action-learning loop. The approach was designed to support systems understanding, strategic focus, methodological practices, and change process knowledge-all of which required double-loop learning. Multiple qualitative methods, i.e., repeated interviews, process diaries, and documents, provided data for conventional content analyses. Results: The new approach was successfully tested on all cases and adopted and sustained by the R&D unit. Participants reported new insights and skills. The development loop facilitated a sense of coherence and control during uncertainty, improved planning and problem analysis, enhanced mapping of context and conditions, and supported problem-solving at both the individual and unit levels. The systems-level view and structured approach helped participants to explain, motivate, and implement change initiatives, especially after working more systematically with mapping, analyses, and goal setting. Conclusions: An easily understood and generalizable model internalized by key organizational actors is an important step before more complex development models can be implemented. SIDSSA facilitated individual and group learning through action-learning and supported systems-level views and structured approaches across multiple organizational levels. Active involvement of diverse organizational functions and levels in the learning process was facilitated. However, the time frame was too short to fully test all aspects of the approach, specifically in reaching beyond the involved managers to front-line staff and patients.
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| 9. |
- Nyström, Monica, et al.
(författare)
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Framtidens välfärdstjänster: Nya arbetssätt för innovativ serviceutveckling inom vård och omsorg : Future wellfare services : New approaches to innovative service development in health and social care (Engelska)
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En växande andel äldre i befolkningen i kombination med en minskande andel arbetskraft ställer allt tuffare krav på utveckling av vård och omsorg. För att klara dessa utmaningar och utveckla framtidens välfärdtjänster krävs nya innovativa arbetssätt. Vi arbetar nu med ett projekt som handlar om verksamhets- och serviceutveckling inom området äldre och vuxna med funktionsnedsättning. Projektet drivs i samarbete med ett tvärvetenskapligt forskarteam från Karolinska institutet, Göteborgs universitet och Luleå tekniska universitet och pågår från november 2009 till och med december 2012. Syftet med projektet är att i regionen Sörmland utveckla och testa arbetssätt som kan stödja innovativ verksamhets- och serviceutveckling inom området äldre och vuxna med funktionsnedsättning. Projektet involverar flera organisatoriska nivåer och huvudmän, inklusive landsting och kommuner. Den teoretiska basen bygger på lärdomar från kvalitets-utveckling, organisatoriskt lärande, innovationsforskning och organisatorisk kreativitet. Upplägget ger förutsättningar för lärande och snabb återkoppling över organisatoriska gränser. Resultaten kan bidra till kunskap om hur olika förutsättningar påverkar lärande, kreativitet och innovationsutveckling inom vård och omsorg, vilket i sin tur underlättar beslut kring strategiska satsningar och ökad kvalitet i vården. Projektet förväntas ge ny kunskap kring organisationers lärandeprocess som kan användas även för andra utvecklingssatsningar.
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| 10. |
- Nyström, Monica, et al.
(författare)
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Locally based research and development units as knowledge brokers and change facilitators in health and social care of older people in Sweden
- 2015
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Ingår i: Evidence & Policy. - : Policy Press. - 1744-2648 .- 1744-2656. ; 11:1, s. 57-80
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Tidskriftsartikel (refereegranskat)abstract
- This article investigates the role of locally based research and development units (R&Ds) focusing on health and social services. Nearly 300 Local R&Ds are funded by the Swedish government with the intention to facilitate knowledge transfer and development of high quality and effective health and social care organisations. Based on analyses of archival data on aims, activities and outputs of R&Ds focusing on care for older people the authors argue that Local R&Ds have potentials to act as knowledge brokers, change agents and researchers, but these overlapping roles need clarified strategies and enactment of a variety of skills.
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