| 1. |
- Albiol, T., et al.
(författare)
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SARNET : Severe accident research network of excellence
- 2010
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Ingår i: PROG NUCL ENERGY. - : Elsevier BV. ; , s. 2-10
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Konferensbidrag (refereegranskat)abstract
- Fifty-one organisations network in SARNET (Severe Accident Research NETwork of Excellence) their research capacities in order to resolve the most important pending issues for enhancing, with regard to Severe Accidents (SA). the safety of existing and future Nuclear Power Plants (NPPs). This project. co-funded by the European Commission (EC) under the 6th Framework Programme, has been defined in order to optimise the use of the available means and to constitute sustainable research groups in the European Union. SARNET tackles the fragmentation that may exist between the different national R&D programmes, in defining common research programmes and developing common computer tools and methodologies for safety assessment. SARNET comprises most of the organisations involved in SA research in Europe, plus Canada. To reach these objectives, all the organisations networked in SARNET contributed to a joint Programme of Activities, which consisted of: Implementation of an advanced communication tool for accessing all project information, fostering exchange of information, and managing documents: Harmonization and re-orientation of the research programmes, and definition of new ones; Analysis of the experimental results provided by research programmes in order to elaborate a common understanding of relevant phenomena; Development of the ASTEC code (integral computer code used to predict the NPP behaviour during a postulated SA), which capitalizes in terms of physical models the knowledge produced within SARNET; Development of Scientific Databases in which all the results of research programmes are stored in a common format (DATANET); Development of a common methodology for Probabilistic Safety Assessment of NPPs; Development of short courses and writing a textbook on Severe Accidents for students and researchers; Promotion of personnel mobility amongst various European organisations. This paper presents the major achievements after four and a half years of operation of the network, in terms of knowledge gained, of improvement of the ASTEC reference code, of dissemination of results and of integration of the research programmes conducted by the various partners. After this first period (2004-2008), co-funded by the EC, a further contract SARNET2 with the EC for the next four years started in April 2009 as part of the 7th Framework Programme. During this period, the networking activities will focus mainly on the remaining pending issues as determined during the first period, experimental activities will be directly included in the common work and the network will evolve toward complete self-sustainability. The bases for such an evolution are presented in the last part of the paper.
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| 2. |
- Anderson, Janet E., et al.
(författare)
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Translating research on quality improvement in five European countries into a reflective guide for hospital leaders : the ‘QUASER Hospital Guide’
- 2019
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 31:8, s. G87-G96
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to translate the findings of the QUASER study into a reflective, dialogic guide to help senior hospital leaders develop an organization wide QI strategy.Design: The QUASER study involved in depth ethnographic research into QI work and practices in two hospitals in each of five European countries. Three translational stakeholder workshops were held to review research findings and advise on the design of the Guide. An extended iterative process involving researchers from each participant country was then used to populate the Guide.Setting: The research was carried out in two hospitals in each of five European countries.Participants: In total, 389 interviews with healthcare practitioners and 803 hours of observations.Intervention: None.Main outcome measure: None.Results: The QUASER Hospital Guide was designed for leadership teams to diagnose their organization’s strengths and weaknesses in the eight QI challenges. The Guide supports organizational dialogue about QI challenges, enables leaders to share perspectives, and helps teams to develop solutions to their situated problems. The Guide includes extensive examples of QI strategies drawn from the data and is published online and on paper.Conclusion: The QUASER Hospital Guide is empirically based, draws on a dialogical approach to Organizational Development and complexity science and can facilitate hospital leadership teams to identify the best solutions for their organization.
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| 3. |
- Ewert, Benjamin, et al.
(författare)
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Any lessons to learn? : Pathways and impasses towards health system resilience in post-pandemic times
- 2023
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Ingår i: Health Economics, Policy and Law. - : CAMBRIDGE UNIV PRESS. - 1744-1331 .- 1744-134X. ; 18:1, s. 66-81
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has been an ultimate challenge for health systems as a whole rather than just single sectors (e.g. hospital care). Particularly, interface management between health system sectors and cooperation among stakeholders turned out to be crucial for an adequate crisis response. Dealing with such interfaces, it is argued in the literature, demands from health care systems to become resilient. One way to analyse this is to focus on the ways in which bottlenecks in health systems are dealt with during the pandemic. This paper investigates six bottlenecks, including overburdened public health agencies, neglected nursing homes and insufficient testing capacities that have been encountered in the health systems of Germany, Sweden and the Netherlands during the pandemic. Based on empirical findings we identify and critically discuss preliminary lessons in terms of health system resilience, an increasingly popular theoretical concept that frames crises as an opportunity for health system renewal. We argue that in practice health system resilience is hindered by path dependencies of national health systems and, owed to the crisis, interim policies that lack ambition for broader reforms.
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| 4. |
- Greenhalgh, Trisha, et al.
(författare)
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Toward a Values-Informed Approach to Complexity in Health Care : Hermeneutic Review
- 2023
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Ingår i: Milbank Quarterly. - : John Wiley & Sons. - 0887-378X .- 1468-0009. ; 101:3, s. 646-674
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Tidskriftsartikel (refereegranskat)abstract
- Policy PointsThe concept of value complexity (complexity arising from differences in people's worldviews, interests, and values, leading to mistrust, misunderstanding, and conflict among stakeholders) is introduced and explained.Relevant literature from multiple disciplines is reviewed.Key theoretical themes, including power, conflict, language and framing, meaning-making, and collective deliberation, are identified.Simple rules derived from these theoretical themes are proposed.
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| 5. |
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| 6. |
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| 7. |
- van Loon, Esther, et al.
(författare)
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Diagnostic Work through Evidence-Based Guidelines : Avoiding Gaps Between Development and Implementation of a Guideline for Problem Behaviour in Elderly Care
- 2014
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Ingår i: Science as Culture. - : Routledge. - 0950-5431 .- 1470-1189. ; 23:2, s. 153-176
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Tidskriftsartikel (refereegranskat)abstract
- Diagnostic work is the reflexive work of figuring out what issues are at stake and determining the scope for action. This work is not generally accommodated by evidence-based guidelines, which generally promote a uniform, predefined approach to solving healthcare problems that risk narrowing the opportunities for diagnostic work in healthcare practice. Consequently, guidelines are often criticised as too general to solve situated, individual healthcare problems and gaps between guidelines and their implementation are often reported. The Netherlands has developed a guideline for problem behaviour in elderly care, explicitly designed for diagnostic work, thus stimulating a situated approach. Relational problem behaviour is highly embedded in its context. The guideline stimulates diagnostic work, which helps to unravel problem behaviour and is opening alternatives in elderly care. Diagnostic work does not transfer guideline development problems to healthcare practice, but simply structures the decision-making process without giving a predefined answer. Diagnostic work is thus important to consider in order to avoid a gap between guideline development and implementation.
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| 8. |
- van Loon, Esther
(författare)
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Reflexive Standardization and Standardized Reflexivity : Development and use of innovations in healthcare practices
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Healthcare is inevitably confronted by many kinds of variation. For example, patients have multiple conditions and wish specific treatment, influencing their care trajectory as this results in different options for treatment or diagnosis (Eddy, 1984). Or different cultural backgrounds between the elderly admitted to nursing homes and their care givers result in communication differences (The, 2008). Or ranking hospitals to gain insight into the best shows substantial variation, depend-ing on who decides the order, the ranking criteria and the publisher, such as the Dutch opinion weekly Elsevier and the newspaper AD (Bal, 2014; Dijkstra & Harverkamp, 2012). Variation is found on all levels of healthcare and, as with the graffiti ex-ample, not all of it is either good or bad. Two dominant developments in healthcare, aimed at improving quality, seem on first sight to ‘stand for’ either good or unwanted variation. The first, the standardization movement seems mainly aimed at reducing unwanted variation, while the second, patient-centred care seeks to allow more individualized care and is likely to be associated with endorsing good variation. As I intend to show in this thesis, labelling variation as good or unwanted depends upon who perceives it in a particular context. The two developments of standardization and patient-centred care do not a priori resemble either ‘unwanted’ or ‘good’ variation. In the rest of this section I will explain this proposition.
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| 9. |
- Wallenburg, Iris, et al.
(författare)
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Advancing to the Next Level : Caring for Evaluative Metrics Monsters in Academia and Healthcare
- 2018
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Ingår i: Living with Monsters? IS&O 2018.. - Cham : Springer. - 9783030040901
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Konferensbidrag (refereegranskat)abstract
- In this paper we use the notions of play and (finite and infinite) games to analyze performance management practices in professional work. Whilst evaluative metrics are often described as ‘monsters’ impacting on professional work, we illustrate how metrics can also become part of practices of caring for such work. Analyzing the use of evaluative metrics in law faculties and in hospitals, we show how finite games – games played to win – and infinite games – games played for the purpose of continuing to play – are intertwined and how this intertwinement affects academic and healthcare work.
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| 10. |
- Wallenburg, Iris, et al.
(författare)
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Caring for Numbers : Performing Healthcare Practices Through Performance Metrics in Sweden and the Netherlands
- 2021
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Ingår i: Worlds of Rankings. - Bingley : Emerald Group Publishing. - 0733-558X. - 9781801171076 - 9781801171052 - 9781801171069 - 1801171068 ; 74, s. 153-172
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Bokkapitel (refereegranskat)abstract
- Performance metrics have become widely used and much lamented - about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use of performance metrics in healthcare regulation and clinical practice. Studying multi-actor settings of performance measurement systems in healthcare in Sweden and the Netherlands, the authors show how regulatory agencies (i.e., the inspectorate and national registries), patients, hospitals, and practitioners engage in the constitution of healthcare practices through developing performance indicators that form the input for ranking, ensuing intensive dialogues on what should be measured and accounted for, and to what effects. The authors analyze this process as caring for numbers. The authors discern two practices of caring for numbers: validating and contexting. Validating refers to the practices of making numbers reflect those practices they intend to depict; contexting is about how with the use of numbers specific contexts of healthcare are built. These processes together emphasize the performative character of numbers as well as the reflexive uses of performativity. The paper shows how collaborative and rather pragmatic practices of caring for numbers co-construct specific practices of healthcare. Though this reflexive entanglement of production and use of numbers actors not only constitute specific performance metrics and ranking practices but also perform healthcare.
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