| 1. |
- Gama, Fábio, Ass. Professor, 1980-, et al.
(författare)
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Implementation Frameworks for Artificial Intelligence Translation Into Health Care Practice : Scoping Review
- 2022
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Ingår i: Journal of Medical Internet Research. - Toronto, ON : JMIR Publications. - 1438-8871. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Significant efforts have been made to develop artificial intelligence (AI) solutions for health care improvement. Despite the enthusiasm, health care professionals still struggle to implement AI in their daily practice.Objective: This paper aims to identify the implementation frameworks used to understand the application of AI in health care practice.Methods: A scoping review was conducted using the Cochrane, Evidence Based Medicine Reviews, Embase, MEDLINE, and PsycINFO databases to identify publications that reported frameworks, models, and theories concerning AI implementation in health care. This review focused on studies published in English and investigating AI implementation in health care since 2000. A total of 2541 unique publications were retrieved from the databases and screened on titles and abstracts by 2 independent reviewers. Selected articles were thematically analyzed against the Nilsen taxonomy of implementation frameworks, and the Greenhalgh framework for the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) of health care technologies.Results: In total, 7 articles met all eligibility criteria for inclusion in the review, and 2 articles included formal frameworks that directly addressed AI implementation, whereas the other articles provided limited descriptions of elements influencing implementation. Collectively, the 7 articles identified elements that aligned with all the NASSS domains, but no single article comprehensively considered the factors known to influence technology implementation. New domains were identified, including dependency on data input and existing processes, shared decision-making, the role of human oversight, and ethics of population impact and inequality, suggesting that existing frameworks do not fully consider the unique needs of AI implementation.Conclusions: This literature review demonstrates that understanding how to implement AI in health care practice is still in its early stages of development. Our findings suggest that further research is needed to provide the knowledge necessary to develop implementation frameworks to guide the future implementation of AI in clinical practice and highlight the opportunity to draw on existing knowledge from the field of implementation science. ©Fábio Gama, Daniel Tyskbo, Jens Nygren, James Barlow, Julie Reed, Petra Svedberg.
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| 2. |
- Karnehed, Sara, 1979-, et al.
(författare)
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Kan samproduktion av framtidens teknik bidra till en hållbar arbetsmiljö för sjuksköterskor?
- 2023
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Konferensbidrag (refereegranskat)abstract
- Svensk primärvård står inför stora utmaningar med en åldrande befolkning och ett ökat antal personer som vårdas i hemmet (Landers et al., 2016). Digital teknik implementeras med förhoppning om att förbättra kommunikationen mellan vårdpersonal och underlätta möjligheterna till egenvård och tillgänglighet för patienter (Socialstyrelsen, 2021). Tidigare studier visar att användningen av digital teknik kan förändra det professionella landskapet (Petersson, 2020) och påverka arbetsmiljö och arbetets innehåll (Ertner, 2019). Trots att teknik som implementeras inom vården bör vara anpassad till hälso- och sjukvårdspersonalens arbete och värderingar (Palmer et al., 2019; Reed et al., 2019) är sjuksköterskor sällan involverade i beslut kring utformning eller implementering av ny teknik (von Gerich et al., 2022). Det behövs mer kunskap om hur digitaliseringen kan ske i samproduktion med sjuksköterskor och utformas så att en god arbetsmiljö bibehålls.Presentationen syftar till att beskriva sjuksköterskors arbete och arbetsmiljö inom hemsjukvården och hur dessa kunskaper kan användas vid utvecklingen och implementeringen av framtida digital teknik.Individuella semi-strukturerade intervjuer har genomförts med 20 sjuksköterskor som arbetar på vårdcentral och inom hemsjukvård i två halländska kommuner. Intervjuerna har analyserats genom kvalitativ innehållsanalys (Hsieh & Shannon, 2005). Implementeringsteoretiska ramverk används för att undersöka hur kunskapen kan inkorporeras vid innovation och implementering av digitala tekniker inom vårdverksamheter (Nilsen, 2015).Preliminära resultat kommer att presenteras vid konferensen.ReferenserErtner, S. M. (2019). Enchanting, evoking, and affecting: the invisible work of technology implementation in homecare. Nordic Journal of Working Life Studies, 9(S5), 33-47.Hsieh, H.-F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis. Qualitative health research, 15(9), 1277-1288.Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D., Lee, T., Moorhead, T., Rodriguez, S., & Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home Health Care Management & Practice, 28(4), 262-278.Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation science : IS, 10(1), 53-53.Palmer, V. J., Weavell, W., Callander, R., Piper, D., Richard, L., Maher, L., Boyd, H., Herrman, H., Furler, J., & Gunn, J. (2019). The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement. Medical humanities, 45(3), 247-257.Petersson, L. (2020). Paving the way for transparency: How eHealth technology can change boundaries in healthcare Lund University].Reed, J. E., Howe, C., Doyle, C., & Bell, D. (2019). Successful healthcare improvements from translating evidence in complex systems (SHIFT-Evidence): simple rules to guide practice and research. International journal for quality in health care, 31(3), 238-244.Socialstyrelsen. (2021). E-hälsa och välfärdsteknik i kommunerna 2021. Uppföljning av den digitala utvecklingen i socialtjänsten och den kommunala hälso-och sjukvården.von Gerich, H., Moen, H., Block, L. J., Chu, C. H., DeForest, H., Hobensack, M., Michalowski, M., Mitchell, J., Nibber, R., & Olalia, M. A. (2022). Artificial Intelligence-based technologies in nursing: A scoping literature review of the evidence. International Journal of Nursing Studies, 127, 104153.
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| 3. |
- Petersson, Lena, 1968-, et al.
(författare)
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Challenges to implementing artificial intelligence in healthcare : a qualitative interview study with healthcare leaders in Sweden
- 2022
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Ingår i: BMC Health Services Research. - London : BioMed Central (BMC). - 1472-6963. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) for healthcare presents potential solutions to some of the challenges faced by health systems around the world. However, it is well established in implementation and innovation research that novel technologies are often resisted by healthcare leaders, which contributes to their slow and variable uptake. Although research on various stakeholders’ perspectives on AI implementation has been undertaken, very few studies have investigated leaders’ perspectives on the issue of AI implementation in healthcare. It is essential to understand the perspectives of healthcare leaders, because they have a key role in the implementation process of new technologies in healthcare. The aim of this study was to explore challenges perceived by leaders in a regional Swedish healthcare setting concerning the implementation of AI in healthcare.Methods: The study takes an explorative qualitative approach. Individual, semi-structured interviews were conducted from October 2020 to May 2021 with 26 healthcare leaders. The analysis was performed using qualitative content analysis, with an inductive approach.Results: The analysis yielded three categories, representing three types of challenge perceived to be linked with the implementation of AI in healthcare: 1) Conditions external to the healthcare system; 2) Capacity for strategic change management; 3) Transformation of healthcare professions and healthcare practice.Conclusions: In conclusion, healthcare leaders highlighted several implementation challenges in relation to AI within and beyond the healthcare system in general and their organisations in particular. The challenges comprised conditions external to the healthcare system, internal capacity for strategic change management, along with transformation of healthcare professions and healthcare practice. The results point to the need to develop implementation strategies across healthcare organisations to address challenges to AI-specific capacity building. Laws and policies are needed to regulate the design and execution of effective AI implementation strategies. There is a need to invest time and resources in implementation processes, with collaboration across healthcare, county councils, and industry partnerships. © The Author(s) 2022.
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| 4. |
- Petersson, Lena, 1968-, et al.
(författare)
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Paving the way for additional forms of boundary work – how the implementation of AI can change healthcare
- 2024
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Konferensbidrag (refereegranskat)abstract
- A digital transformation of Swedish healthcare is currently taking place, and artificial intelligence (AI) is meant to solve many of the healthcare sector's challenges. The objective of this paper is to describe and analyze how the boundaries around the physicians' work could change when AI is implemented in healthcare and what boundary work actors on different levels in a healthcare system conduct. We conducted 26 semi-structured interviews with healthcare leaders and 18 with healthcare managers and professionals. The result shows that the leaders, healthcare managers, and healthcare professionals describe different types of boundary work in regard to the implementation of AI. The implementation of AI in healthcare could change the boundaries around the healthcare professionals’ work and generate new kinds of boundary work that could affect the implementation. These findings can inform both practice and policy.
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| 5. |
- Petersson, Lena, 1968-, et al.
(författare)
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This far you may come, but no farther: How the implementation of AI triggered boundary work among healthcare professionals
- 2024
-
Konferensbidrag (refereegranskat)abstract
- A digital transformation of Swedish healthcare is currently taking place, and artificial intelligence (AI) is meant to solve many of the healthcare sector's challenges. The objective of this paper is to describe and analyze how the boundaries around the physicians' work could change when AI is implemented in healthcare and what boundary work actors on different levels in a healthcare system conduct. We conducted 26 semi-structured interviews with healthcare leaders and 18 with healthcare managers and professionals. The result shows that the leaders, healthcare managers, and healthcare professionals describe different types of boundary work in regard to the implementation of AI. The implementation of AI in healthcare could change the boundaries around the healthcare professionals’ work and generate new kinds of boundary work that could affect the implementation. These findings can inform both practice and policy.
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| 6. |
- Siira, Elin, 1987-, et al.
(författare)
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Healthcare leaders’ experiences of implementing artificial intelligence for medical history-taking and triage in Swedish primary care : an interview study
- 2024
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Ingår i: BMC Primary Care. - London : BioMed Central (BMC). - 2731-4553. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) holds significant promise for enhancing the efficiency and safety of medical history-taking and triage within primary care. However, there remains a dearth of knowledge concerning the practical implementation of AI systems for these purposes, particularly in the context of healthcare leadership. This study explores the experiences of healthcare leaders regarding the barriers to implementing an AI application for automating medical history-taking and triage in Swedish primary care, as well as the actions they took to overcome these barriers. Furthermore, the study seeks to provide insights that can inform the development of AI implementation strategies for healthcare.Methods: We adopted an inductive qualitative approach, conducting semi-structured interviews with 13 healthcare leaders representing seven primary care units across three regions in Sweden. The collected data were subsequently analysed utilizing thematic analysis. Our study adhered to the Consolidated Criteria for Reporting Qualitative Research to ensure transparent and comprehensive reporting.Results: The study identified implementation barriers encountered by healthcare leaders across three domains: (1) healthcare professionals, (2) organization, and (3) technology. The first domain involved professional scepticism and resistance, the second involved adapting traditional units for digital care, and the third inadequacies in AI application functionality and system integration. To navigate around these barriers, the leaders took steps to (1) address inexperience and fear and reduce professional scepticism, (2) align implementation with digital maturity and guide patients towards digital care, and (3) refine and improve the AI application and adapt to the current state of AI application development.Conclusion: The study provides valuable empirical insights into the implementation of AI for automating medical history-taking and triage in primary care as experienced by healthcare leaders. It identifies the barriers to this implementation and how healthcare leaders aligned their actions to overcome them. While progress was evident in overcoming professional-related and organizational-related barriers, unresolved technical complexities highlight the importance of AI implementation strategies that consider how leaders handle AI implementation in situ based on practical wisdom and tacit understanding. This underscores the necessity of a holistic approach for the successful implementation of AI in healthcare. © The Author(s) 2024.
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| 7. |
- Tyskbo, Daniel, Dr. 1985-, et al.
(författare)
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Brains exposed : How new imaging technology reconfigures expertise coordination in neurosurgery
- 2022
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Ingår i: Social Science and Medicine. - Oxford : Elsevier. - 0277-9536 .- 1873-5347. ; 292
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the consequences of the uptake of novel medical technology for expertise coordination among specialists. Building on a 40-month field study, we show how the introduction of iMRI triggered a significant change in temporal, interactional and role dimensions of coordination. We trace the origin of those changes to the novel role the images started to play in surgery: iMRI generated new forms of visibility of the brain (offering real-time, more precise imaging) and new forms of ambiguity for clinical action (representing the brain undergoing manipulation). In response to this dual nature of images, specialists reconfigured how they engage with each other: aligning temporal rhythms of their corresponding work practices, shifting their interactions to focus more on dialog and synchronous mutual exploration of images, and delegating increased weight to radiological judgement for guiding immediate surgical action. We discuss the implications of our findings for research on expertise coordination and on the consequences of novel medical technologies for situated practice. © 2021 The Authors
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| 8. |
- Tyskbo, Daniel, Dr. 1985-
(författare)
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Conceptualizing talent in public sector municipalities
- 2021
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Ingår i: International Review of Administrative Sciences. - London : Sage Publications. - 0020-8523 .- 1461-7226. ; 89:2, s. 519-535
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Tidskriftsartikel (refereegranskat)abstract
- While talent management is considered a top priority among practitioners and constitutes a major research area, the actual meaning of talent still remains largely undefined. In response to a lack of clarity and empirical basis regarding the notion of talent, various calls have been made for exploring how organizations conceptualize talent, particularly in the public sector context. This article answers these calls by adopting a qualitative in-depth case study to explore how senior Human Resources (HR) managers in public sector municipalities conceptualize talent in practice. The findings illustrate how HR managers use a variety of conceptualizations of talent. We analyze and theorize this variation and the ways of conceptualizing talent using two conceptualization categories: non-contextual conceptualizations, which are general and related to official practices (i.e. talentas future leaders and talent as a general commitment and drive forward), and contextual conceptualizations, which are specific and related to informal assumptions (i.e. talent as Trojans and specialists, talent as individual agility, and talent as public service awareness). © The Author(s) 2021.
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| 9. |
- Tyskbo, Daniel, Dr. 1985-
(författare)
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Defending and Expanding Boundaries : Exploring How COVID-19 Triggered Boundary Work Among HR Managers in the Public Sector
- 2023
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Ingår i: Review of Public Personnel Administration. - Thousand Oaks, CA : Sage Publications. - 0734-371X .- 1552-759X.
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Tidskriftsartikel (refereegranskat)abstract
- While important insights have been provided into the role of HR managers in performing change in the workplace, still little is known about how HR managers themselves are shaped by change, in particular in relation to those changes triggered by radical or disruptive shock events and crisis situations, and in the public sector context. In this study, we aim to address this, using an exploratory qualitative interview study to explore how the serious and profound COVID-19 pandemic triggered boundary work among HR managers in public sector municipalities. Our findings illustrate that COVID-19 triggered HR managers to engage in boundary work in two main ways: either by defending their boundaries (through the two practices of counteracting dumping and counteracting shirking) or by expanding them (through the two practices of facilitating self-fulfillment and facilitating status-enhancement). We discuss how this variation is related to whether the HR managers experienced and made sense of the pandemic mainly as a threat—of being forced into unwanted responsibility—or if they experienced and made sense of it mainly as an opportunity to take advantage of the situation. In showing this, the study makes a number of important contributions to both theory and practice. © The Author(s) 2023.
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| 10. |
- Tyskbo, Daniel, Dr. 1985-, et al.
(författare)
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Karma chameleon : Exploring the leadership complexities of middle managers in the public sector
- 2023
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Ingår i: International Public Management Journal. - Philadelphia, PA : Routledge. - 1096-7494 .- 1559-3169. ; 26:4, s. 548-569
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Tidskriftsartikel (refereegranskat)abstract
- While leadership is one of the most discussed concepts in the social sciences, there is a need for more scholarly research that examines the ambiguous leadership position of middle managers, and how their leadership work is perceived in practice. In this article, we follow the recent research turn of adopting a social constructionist view of leadership, and make use of metaphors to answer the following research question: how are middle managers in the public sector managing the expectations and demands from both top management and subordinates, and what are some of its consequences? We study this in the public sector, a context of particular importance but one that has often been neglected in previous research. Through a qualitative in-depth case study, based on observations, interviews, and organizational documents, our findings show that middle managers were trapped in the way they moved between being constructed as a leader and a follower, along what we call a leader-follower pendulum, and in the way they enacted two different leadership metaphors: the buddy and the commander. These aspects jointly contribute to a complex and ambiguous situation for middle managers, which in turn gives rise to alienation and the constant strive to fit in, something that we metaphorically refer to as “karma chameleon.” © 2022 The Author(s).
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