| 1. |
- Elg, Mattias, et al.
(författare)
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Public quality – for whom and how? : Integrating public core values with quality management
- 2017
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Ingår i: Total Quality Management and Business Excellence. - Abingdon-on-Thames : Routledge. - 1478-3363 .- 1478-3371. ; 28:3-4, s. 379-389
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Tidskriftsartikel (refereegranskat)abstract
- Quality management (QM) plays an important role in public organisations’ efforts to create better access to, and effectiveness of, specific services. When transferring QM models from market-based firms to public services provided by public organisations, several basic contrasts and even contradictions must be addressed. Core values of the public sector differ from those of the private sector, but what are the consequences of this distinction? In this article we discuss the importance of four central arguments on public services: rights and access have to be considered; equality is an important facet of public services; coerciveness is a unique feature of public services; and legitimacy can be improved by high-quality services. These arguments have not been discussed explicitly in the context of QM. Adding these central aspects of public services to the QM field could generate more sustainable ways for developing quality and QM in public services in particular and the public sector in general.
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| 2. |
- Örnerheim, Mattias, 1974-, et al.
(författare)
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Implementering i vården : En kunskapsöversikt om beslutsnivåer och professionsperspektiv
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Hälso- och sjukvården liksom socialtjänsten är under ständig förändring – medicinska framsteg skapar nya möjligheter till behandling samtidigt som behoven av hälso- och sjukvård och socialtjänst ökar i takt med att allt fler lever längre med kroniska sjukdomar. Socialtjänsten kommer att behöva stödja fler med långvariga och komplexa behov, vilket band annat kommer att ställa krav på ändrade arbetssätt. En fortsatt utveckling i vården och omsorgen är viktigt för att i dag och i framtiden kunna tillhandahålla en god vård och omsorg som patienter och brukare känner förtroende för.Samtidigt finns tecken på att utvecklingen och lärandet inte sker i den omfattning som behövs. I olika analyser har Vårdanalys genom åren visat att lärandet mellan olika verksamheter och huvudmän är begränsat. Orsakerna bakom det är flera.Hösten 2017 initierade vi ett forskningsuppdrag med ambitionen att utifrån litteraturen identifiera övergripande utmaningar när det gäller implementering i hälso- och sjukvården och socialtjänsten. Vi gav professor Mattias Elg och postdoktor Mattias Örnerheim vid institutionen för ekonomisk och industriell utveckling (IEI), Linköpings universitet, uppdraget att presentera en kunskapsöversikt på detta tema.Deras översikt har varit ett värdefullt bidrag till Vårdanalys arbeten under 2017 och 2018 som på olika sätt analyserat utvecklingsarbete och deras förutsättningar att bidra till långsiktig utveckling. Det är vår förhoppning att den här promemorian kan tjäna som ett kunskapsunderlag i den fortsatta diskussionen om hur vi kan skapa bättre förutsättningar till lärande och utveckling i vården och omsorgen.Den här promemorian är författarnas redovisning av forskningsuppdraget i sin helhet och de står själva för innehållet.
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| 3. |
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| 4. |
- Andersson, Ann-Christine, et al.
(författare)
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Adapting a survey to evaluate quality improvements in Swedish healthcare
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Quality improvement initiatives, a concept with origins in the manufacturing sector, have increased within the Swedish healthcare sector in recent decades. These efforts to improve quality can be seen as a response to demands for more cost-effectiveness and better medical results. However, studies have shown that less than 40% of these initiatives are successful (Olsson et al. 2007). The reason why specific improvement initiatives in healthcare fail or succeed is, therefore, a central question in studies of change. To be able to manage, improve and implement quality initiatives and improvements it is necessary to observe, measure and evaluate. Batalden and Davidoff (2007) point out that if there are no mechanisms to measure the changes, there is no way to know whether they actually lead to improvements. A more severe consequence, as stated by Sorian (2006), is that we sometimes accept an organizational system that not only fails to reward or encourage quality improvements but also sometimes punishes those who prioritize quality over cost-effectiveness. The need for more evidence about how to organize and manage new quality initiatives is identified as an important task within studies of healthcare improvement (Walshe 2009, Olsson et al. 2007).
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| 5. |
- Andersson, Ann-Christine, et al.
(författare)
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Evaluating a Breakthrough Series Collaborative in a Swedish Health Care Context
- 2014
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Ingår i: Journal of Nursing Care Quality. - : Lippincott Williams & Wilkins. - 1057-3631 .- 1550-5065. ; 29:2, s. E1-E10
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the use of the Breakthrough Series Collaborative methodology in a Swedish county council improvement program, comparing measurements at the beginning and after 6 months. A questionnaire was used, and improvement processes and outcomes were analyzed. The results showed an overall large engagement in improvements, although the methodology and facilitators were seen as only moderately supportive.
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| 6. |
- Andersson, Ann-Christine, et al.
(författare)
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Evaluating a Breakthrough Series Collaborative in a Swedish healthcare context
- 2013
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Since the mid-1990s, increased attention has been placed on quality improvement and patient safety within the healthcare context. This study aims to evaluate the use of the Breakthrough Series Collaborative methodology in a Swedish county council improvement program, comparing measurements at the beginning and after six months. A questionnaire was used, and improvement processes and outcomes were analysed. The results showed an overall large engagement in improvements, although the methodology and the facilitators were seen as only moderately supportive. Nursing educators have highlighted the importance of improvement education amongst healthcare professions, and nurses could play an active role in improving healthcare practices and patient safety.
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| 7. |
- Andersson, Ann-Christine, et al.
(författare)
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Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare
- 2013
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 13:48
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Tidskriftsartikel (refereegranskat)abstract
- Background: Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods: A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results: The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions: The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.
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| 8. |
- Andersson, Ann-Christine, et al.
(författare)
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Five Types of Practice-Based ImprovementIdeas in Health Care Services: An EmpiricallyDefined Typology
- 2011
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Ingår i: Quality Management in Health Care. - : Lippincott Williams & Wilkins. - 1063-8628 .- 1550-5154. ; 20:2, s. 122-130
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to empirically identify and present different kinds of practice-based improvement ideas developed in health care services. The focus is on individual placement needs, problems/issues, and the ability to organize work on the development, implementation, and institutionalization of ideas for the health care sector. This study is based on a Swedish county council improvement program. Health care departments and primary health care centers in the Kalmar County Council were invited to apply for money to accomplish improvement projects. A qualitative content analysis was done of 183 proposed applications from various health care departments and primary health care centers. The following 5 types of improvement projects were identified: organizational process, evidence and quality, competence development, process technology, and proactive patient work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. These projects point to the various problems and experiences health care professionals encounter in their day-to-day work. To generalize beyond this improvement program and to validate the typology, we applied it to all articles found when searching for quality improvement projects in the journal Quality Management in Health Care during the last 2 years and found that all of them could be fitted into at least 1 of those 5 categories. This article provides valuable insights into the current state of improvemen work in Swedish health care, and will serve as a foundation for further investigations in this quality improvement program.
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| 9. |
- Andersson, Ann-Christine, et al.
(författare)
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Improvement Strategies : Forms and Consequences for Participation in Healthcare Improvement Projects
- 2013
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- From a management point of view there are many different approaches from which to choose in how to engage staff in initiatives to improve performance. The present study investigates how two different types of improvement strategies stimulate and encourage involvement of different professional groups in healthcare organizations. The first type, Designed Improvement Processes, is constituted of a methodologically guided collaborative program. The second type, Intrapreneurship Projects, is characterized by an “intrapreneur” working with an improvement project in a rather free manner. The data analysis was carried out through classifying the participants´ profession, position, gender and the organizational administration of which they were a part. The result showed that nurses were the largest group participating in both improvement initiatives. Physicians were also well represented, although they seemed to prefer the less structured Intrapreneurship Projects approach. Assistant nurses, being the second largest staff group, were poorly represented in both initiatives. This indicates that the benefits and support for one group may push another group aside. Managers need to give prerequisites and incentives for staff who do not participate to do so.
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| 10. |
- Andersson, Ann-Christine, et al.
(författare)
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Practice-based improvement ideas in healthcare services
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective. The present study will contribute to knowledge of how practitioners in a healthcare region engage in quality improvement initiatives. The focus is on individual placement needs, problems/issues and the ability to organize work on the development, implementation and institutionalization of ideas for the healthcare sector. Design and settings. This study is based on the Kalmar county council Improvement Program. Healthcare departments and primary healthcare centers in the county council were invited to apply for money to accomplish improvement projects. The aim is to empirically identify and present the different kinds of practice-based improvement ideas developed in healthcare services. The 202 applications received from various healthcare departments and primary healthcare centers are analyzed using qualitative content analysis. Outcome and Results. Five types of improvement projects were identified: Organizational Process; Evidence and Quality; Competence Development; Process Technology; and Proactive Patient Work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. In addition, a common characteristic among the studied project applications is to increase patient safety, effectiveness and availability of care, and education/training. Those intentions are found in many of the applications and therefore give the impression of being most important to caregivers today. Conclusions. These projects point to the various problems and experiences healthcare professionals encounter in their day-to-day work. This paper provides valuable insights into the current state of improvement work in Swedish healthcare, and will serve as a foundation for further investigations in this quality program.
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