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- Gremyr, Ida, 1975, et al.
(författare)
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The roles of quality departments and their influence on business results
- 2021
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Ingår i: Total Quality Management and Business Excellence. - : Informa UK Limited. - 1478-3371 .- 1478-3363. ; 32:7-8, s. 886-897
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the various roles of quality departments and investigates whether their roles have different influence on business results. Based on a survey of quality managers in 211 Swedish organisations, the analysis identifies four roles of quality departments: firefighters, auditors, process improvers, and orchestrators. The roles vary in their predominant adoption of Quality Management practices ranging from a narrow scope focusing on quality management systems to a broader scope, based on multiple practices. An analysis was performed to identify how each of the identified roles influences business results. The results show that quality departments with a broad focus, combining both explorative and exploitative quality practices, contribute the most to business results.
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- Arwin, Henrietta, 1977, et al.
(författare)
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Advancing Digital-Physical Relational Primary Healthcare: Four Triadic Perspectives
- 2022
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- One significant development in healthcare operations and delivery is patient centricity and focus on the digital and face-to-face service encounter between the patient (end-user) and the physician (professional provider). Digitalization offers great potential in this transition, and is often seen as viable for discrete, transactional services, however, relational values such as equality and continuity in primary healthcare call for a better understanding of this for patients with chronical, long-term needs. To this end, this paper presents a relational approach to digitalization of professional services in primary healthcare. A multi-actor approach, conceptually and empirically informed concept mapping of patients, physicians,and line managers, resulting in seven clusters outlining what a developed contact between patients and physicians means. Derived from this are four triadic perspectives that outline how relational primary healthcare can be advanced:“continuity”, “person-centred”, “interaction quality” and “developability”
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- Bergman, Bo, 1943, et al.
(författare)
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An Emerging Science of Improvement in Health Care
- 2015
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Ingår i: Quality Engineering. - : Informa UK Limited. - 1532-4222 .- 0898-2112. ; 27:1, s. 17-34
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT The purpose of this article is to describe the emerging science of improvement in health care and to add a perspective from the industrial quality improvement movement, the use of data from quality registers, and to give some personal reflections and suggestions. Furthermore, we want to introduce to the broader quality management community what is happening in healthcare with respect to quality improvement. We will discuss some of the challenges of the health care system and the current status of a science ofimprovement and give some suggestions for further improvements to the area.We discuss a possible extension of improvement knowledge and thetheoretical and practical arsenal of a science of improvement, in particular, understanding variation and implications for the use of, for, example controlcharts. In addition, the normative side of a science of improvement is discussed. The article ends with some brief reflections of use for future research agendas.
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- Book, Stefan, 1966, et al.
(författare)
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Perceptions of Improvement Work in Swedish Health Care: Implications for Improvement Practices.
- 2003
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Ingår i: Quality Management in Health Care. - 1063-8628 .- 1550-5154. ; 12:4, s. 217-224
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This study explored perceptions of improvement work in Swedish health care. The article discusses effects that these perceptions may have on improvement processes. As part of a broader study surveying managers' (n = 2313) view of improvement work in Swedish health care, this study focused on those 845 managers who regarded their improvement work as bringing about benefits. Three underlying factors that may characterize the managers' perceptions are exposed. More than 50% of the respondents perceive a complexity in the practices and techniques associated with improvement work. Furthermore, approximately 50% of the managers recognize a conflict in the meeting between the improvement work and the organization. This indicates that adaptation is a primary concern in this work. The managers' perceptions also reveal that the experience of improvement work in Swedish health care may be positive, although the perception is that it does not necessarily generate more health care per monetary unit.ABSTRACT FROM AUTHOR
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| 7. |
- Colldén, Christian, 1983, et al.
(författare)
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A value-based taxonomy of improvement approaches in healthcare
- 2017
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Ingår i: Journal of Health, Organisation and Management. - 1477-7266. ; 31:4, s. 445-458
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare. Design/methodology/approach: Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs – lean, value-based healthcare, and patient-centered care – are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy. Findings: Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as “health outcomes” is widespread, but healthcare professionals are less likely than managers to also view value as a process. Originality/value: The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging “value era”. It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.
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| 8. |
- Colldén, Christian, 1983, et al.
(författare)
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From “Invented here” to “Use it everywhere!”: A Learning health system from bottom and/or top?
- 2022
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Ingår i: Learning Health Systems. - : Wiley. - 2379-6146. ; 6:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Departing from a practical problem of how to use digitalization to improve care quality and efficiency, this paper investigates how the concept of Learning Health Systems (LHSs) can be applied to an existing organization. LHSs offer a vision for how healthcare can accelerate both scale-up of innovations and quality improvements at all levels. However, aligning stakeholders at different levels to convergent development is challenging and translation and adaptation of the LHS concept to fit with the existing organization is essential. Methods: A one-year longitudinal action research (AR) study was conducted within five psychiatric departments at the Sahlgrenska University Hospital in Gothenburg, Sweden. Translation of the LHS concept to the local circumstances within the organization was set as the aim, to both improve practice and further scientific understanding. An AR group led the practical and scholarly work and holistic data were collected, including field notes, documents, recordings, and workshops. Data were analyzed by an insider-outsider approach. Results: The one-year study is described to provide insights into the process of designing a locally adapted LHS using an AR approach. Practical needs were identified and iteratively matched with theory to form a local LHS model. A conflict between top-down and bottom-up views on development emerged, where higher-level management tended to prioritize uniform solutions and developers local learning. An adapted solution to balance these approaches was negotiated, consisting of a technical and an organizational part. Conclusions: The conflict between top-down and bottom-up approaches for how to implement LHSs needs to be considered both in practical work to transform care organizations and in scientific studies of LHSs. The approach to translate, rather than instrumentally implement, LHSs to real-world settings is suggested as advantageous. Furthermore, designing such endeavors as AR projects can provide excellent conditions to create LHSs that work in practice.
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| 10. |
- Colldén, Christian, 1983, et al.
(författare)
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Value-based healthcare translated: A complementary view of implementation
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Interest in the implementation of various innovations (e.g. medical interventions and organizational approaches) has increased rapidly, and management innovations (MIs) are considered particularly complex to implement. In contrast to a traditional view that innovations are implemented, some scholars have promoted the view that innovations are translated into contexts, a view referred to as translation theory. The aim of this paper is to investigate how a translation theory perspective can inform the Consolidated Framework of Implementation Research (CFIR) to increase understanding of the complex process of putting MIs into practice. The empirical base is a two-year implementation of the MI Value-Based Health Care (VBHC) to a psychiatric department in a large Swedish hospital. Methods: In this longitudinal case study, a qualitative approach was applied using an insider researcher with unique access to data, who followed the implementation starting in 2015. Data sources includes field notes, documents, and audio recordings of meetings and group reflections which were abridged into an event data file structured by CFIR domains. In a joint analysis, an outsider researcher was added to strengthen the analysis and mitigate potential bias. Results: Two themes were identified, for which CFIR did not satisfactorily explain the findings. First, the intervention characteristics (i.e. the content of the MI) were modified along the process and, second, the process did not follow predefined plans. However, the project was still perceived to be successful by internal and external stakeholders. Conclusions: The paper proposes three ways in which translation theory can inform CFIR when applied to MIs: 1) strength of evidence is not as important for MIs as for medical and technical innovations; 2) adaptability of the MI can be emphasized more strongly, and 3) it can be more fruitful to view implementation as a dynamic process rather than seeing it as a matter of planning and execution. For managers, this implies encouragement to seize the opportunity to translate MIs to fit their organization, rather than to aim to be true to an original concept.
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