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| 2. |
- Astnell, Sandra, et al.
(författare)
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Integrating health promotion with quality improvement in a Swedish hospital
- 2015
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Ingår i: Health Promotion International. - : Oxford University Press (OUP). - 0957-4824 .- 1460-2245. ; 31:3, s. 495-504
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Tidskriftsartikel (refereegranskat)abstract
- Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals.
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| 3. |
- Augustsson, Hanna, et al.
(författare)
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Investigating Variations in Implementation Fidelity of an Organizational-Level Occupational Health Intervention
- 2015
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 22:3, s. 345-355
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Tidskriftsartikel (refereegranskat)abstract
- The workplace has been suggested as an important arena for health promotion, but little is known about how the organizational setting influences the implementation of interventions. The aims of this study are to evaluate implementation fidelity in an organizational-level occupational health intervention and to investigate possible explanations for variations in fidelity between intervention units. The intervention consisted of an integration of health promotion, occupational health and safety, and a system for continuous improvements (Kaizen) and was conducted in a quasi-experimental design at a Swedish hospital. Implementation fidelity was evaluated with the Conceptual Framework for Implementation Fidelity and implementation factors used to investigate variations in fidelity with the Framework for Evaluating Organizational-level Interventions. A multi-method approach including interviews, Kaizen notes, and questionnaires was applied. Implementation fidelity differed between units even though the intervention was introduced and supported in the same way. Important differences in all elements proposed in the model for evaluating organizational-level interventions, i.e., context, intervention, and mental models, were found to explain the differences in fidelity. Implementation strategies may need to be adapted depending on the local context. Implementation fidelity, as well as pre-intervention implementation elements, is likely to affect the implementation success and needs to be assessed in intervention research. The high variation in fidelity across the units indicates the need for adjustments to the type of designs used to assess the effects of interventions. Thus, rather than using designs that aim to control variation, it may be necessary to use those that aim at exploring and explaining variation, such as adapted study designs.
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| 5. |
- Mazzocato, Pamela, et al.
(författare)
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Kaizen practice in healthcare : a qualitative analysis of hospital employees' suggestions for improvement
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Kaizen, or continuous improvement, lies at the core of lean. Kaizen is implemented through practices that enable employees to propose ideas for improvement and solve problems. The aim of this study is to describe the types of issues and improvement suggestions that hospital employees feel empowered to address through kaizen practices in order to understand when and how kaizen is used in healthcare.METHODS: We analysed 186 structured kaizen documents containing improvement suggestions that were produced by 165 employees at a Swedish hospital. Directed content analysis was used to categorise the suggestions into following categories: type of situation (proactive or reactive) triggering an action; type of process addressed (technical/administrative, support and clinical); complexity level (simple or complex); and type of outcomes aimed for (operational or sociotechnical). Compliance to the kaizen template was calculated.RESULTS: 72% of the improvement suggestions were reactions to a perceived problem. Support, technical and administrative, and primary clinical processes were involved in 47%, 38% and 16% of the suggestions, respectively. The majority of the kaizen documents addressed simple situations and focused on operational outcomes. The degree of compliance to the kaizen template was high for several items concerning the identification of problems and the proposed solutions, and low for items related to the test and implementation of solutions.CONCLUSIONS: There is a need to combine kaizen practices with improvement and innovation practices that help staff and managers to address complex issues, such as the improvement of clinical care processes. The limited focus on sociotechnical aspects and the partial compliance to kaizen templates may indicate a limited understanding of the entire kaizen process and of how it relates to the overall organisational goals. This in turn can hamper the sustainability of kaizen practices and results.
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| 6. |
- McGrath, Cormac, et al.
(författare)
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Exploring dimensions of change : the case of MOOC conceptions
- 2017
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Ingår i: International journal for academic development. - 1360-144X .- 1470-1324. ; 22:3, s. 257-269
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Tidskriftsartikel (refereegranskat)abstract
- This paper addresses a relatively new phenomenon in higher education, Massive Open Online Courses (MOOCs), and explores conceptions around this new and emerging development from the perspective of a number of stakeholders in the university. A phenomenographic approach is adopted. The study explores how different stakeholders at a university perceive the MOOC phenomenon, and reflects on how the many conceptions stakeholders adhere to are made meaningful for academic developers in their role as 'partners in arms'. The conceptions run across a continuum from the local and narrow to the global and broad. The study identifies challenges to change agency in a higher education institution.
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| 7. |
- McGrath, Cormac, et al.
(författare)
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The Ebb and Flow of Educational Change : Change Agents as Negotiators of Change
- 2016
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Ingår i: Teaching and Learning Inquiry. - : International Society for the Scholarship of Teaching and Learning. - 2167-4779 .- 2167-4787. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we are concerned with how change agents go about and experience change implementation in higher education. We identified change agents and interviewed them about how they implement change. Empirical data was analysed using a theoretical framework of change. The findings suggest that change in the university is enacted through a process of negotiation. The findings of this study may offer academic developers, pedagogical leaders, and change agents insight into the complex nature of the change process and inform change agents as to the complex nature and importance of their role.
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| 9. |
- Stenfors-Hayes, Terese, et al.
(författare)
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A phenomenographic approach to research in medical education
- 2013
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Ingår i: Medical Education. - : Blackwell Publishing. - 0308-0110 .- 1365-2923. ; 47:3, s. 261-270
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Tidskriftsartikel (refereegranskat)abstract
- Context Phenomenography is a qualitative approach to research which has revolutionised the way that researchers and teachers think about the processes and outcomes of learning in higher education. Phenomenography has also been used successfully in medical and health care research for the last 20 years. Phenomenography provides a lens through which to view certain types of research question. It also provides direction for how to empirically carry out the research.Methods This paper introduces phenomenography as a viable qualitative approach for use in medical education research.Results A phenomenographic study maps the qualitatively different ways in which people experience a phenomenon. This type of study can have an important impact on, for example, patient communication, clinical practice and health care education.Conclusion We suggest that a phenomenographic approach can be used to explore many medical education research issues, and can facilitate more solid links between research and educational development and change.
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| 10. |
- Stenfors-Hayes, Terese, et al.
(författare)
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Being a mentor for undergraduate medical students enhances personal and professional development
- 2010
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Ingår i: MEDICAL TEACHER. - : Informa UK Limited. - 0142-159X .- 1466-187X. ; 32:2, s. 148-153
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study aims to evaluate an undergraduate mentor programme from the mentors perspective, focusing particularly on the effect of mentorship, the relationships between mentoring and teaching and the mentors perceived professional and personal development. Methods: Data was gathered through a questionnaire to all 83 mentors (response rate 75%) and semi-structured interviews with a representative sample of 10 mentors. Results: Findings show, for example, that a majority of respondents developed their teaching as a result of their mentorship and improved their relations with students. Most respondents also claimed that being a mentor led to an increased interest in teaching and increased reflections regarding their own values and work practices. Conclusion: Being a mentor was perceived as rewarding and may lead to both personal and professional development.
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