| 1. |
- Alharbi, Tariq, 1979, et al.
(författare)
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Experiences of person-centred care – patients’ perceptions: qualitative study
- 2014
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Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 13:28
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Tidskriftsartikel (refereegranskat)abstract
- Background Patient care models have been implemented and documented worldwide. Many studies have focused on features that hinder and facilitate the shift to such models, including the implementation process, staff involvement, resistance to new models and cultural dimensions. However, few studies have identified the potential effects of such new care models from a patient perspective. The aim of the present study was to investigate whether patients did in fact perceive the intentions of partnership in the new care model 1 year after its implementation. Methods Sixteen participants were interviewed, selected from two wards in a medical department where a new care model had been implemented 1 year earlier. A directed deductive content analysis was selected. The aim of the directed approach to content analysis was to investigate to what extent the new care model had been implemented, using patients’ perspectives to describe the level of implementation. A coding framework was developed based on a theoretical paper that described the key features of the new care model. Results The implementation of person-centred care had clearly occurred to a large degree, even if some patients appeared not to have been exposed to the model at all. Aspects of the newly implemented care model were obvious; however, it was also clear that implementation was not complete. The analysis showed that patients felt listened to and that their own perception of the situation had been noted. Patients spontaneously expressed that they felt that the staff saw them as persons and did not solely focus on their disease. It was also stated that not every ailment or aspect of a patient’s illness needed to be addressed or resolved for open listening to be perceived as a positive experience. Conclusions The findings indicate that even though some patients were not interested in participating and playing an active role in their own care, this might relate to a lack of understanding on how to invite them to do so and to increase their confidence. To change healthcare from a paternalistic system to care where patients are seen as partners may require pedagogical skills.
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| 2. |
- Alharbi, Tariq, 1979, et al.
(författare)
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Organizational culture and the implementation of person centered care: Results from a change process in Swedish hospital care
- 2012
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510. ; 108:2-3, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.
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| 3. |
- Alharbi, Tariq, 1979, et al.
(författare)
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The impact of organizational culture on the outcome of hospital care: After the implementation of person-centred care
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:1, s. 104-110
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To measure the effect of organizational culture on health outcomes of patients 3 months after discharge. Methods: a quantitative study using Organizational Values Questionnaire (OVQ) and a health-related quality of life instrument (EQ-5D). A total of 117 nurses, 69% response rate, and 220 patients answered the OVQ and EQ-5D, respectively. Results: The regression analysis showed that; 16% (R2 = 0.02) of a decreased health status, 22% (R2 = 0.05) of pain/discomfort and 13% (R2 = 0.02) of mobility problems could be attributed to the combination of open system (OS) and Human Relations (HR) cultural dimensions, i.e., an organizational culture being dominated by flexibility. Conclusions: The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.
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| 4. |
- Berner, Andreas, et al.
(författare)
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STREET: Swedish Tool for Risk/Resource Estimation at EvenTs. Part one, risk assessment – face validity and inter–rater reliability
- 2015
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Ingår i: Journal of Acute Disease. - 2221-6189. ; 4:1, s. 37-43
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Tidskriftsartikel (refereegranskat)abstract
- Objective To develop a validated and generalized high reliability organizations collaborative tool in order to conduct common assessments and information sharing of potential risks during mass-gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.37 and a mean accuracy of 62% of the tool. Conclusions The collaboration tool, “STREET”, showed acceptable reliability and validity to be used as a foundation for high reliability organization collaboration in a simulated environment. However, the lack of reliability in one of the cases highlights the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but need, on the other hand, an already developed tool.
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| 5. |
- Berner, A, et al.
(författare)
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STREET: Swedish tool for risk /resource estimation at events. Part two, resource assessment -face validity and inter-rater reliability.
- 2015
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Ingår i: Journal of acute disease. - 2221-6189. ; 4:2, s. 112-116
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Tidskriftsartikel (refereegranskat)abstract
- Objective To develop a validated and generalized collaborative tool to be utilized by high reliability organizations in order to conduct common resource assessment before major events and mass gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.44 and a mean accuracy of 61% of the tool. Conclusions A better collaboration ability and more accurate resource assessment with acceptable reliability and validity were shown in this study to be used as a foundation for resource assessment before major events/mass-gathering in a simulated environment. However, the result also indicates the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but needs, on the other hand, an already developed tool.
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