| 1. |
|
|
| 2. |
- Andersson, Johanna, et al.
(author)
-
Actor or arena : Contrasting translations of a law on interorganizational integration
- 2012
-
In: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 26:6, s. 778-793
-
Journal article (peer-reviewed)abstract
- Purpose – A Swedish framework law has enabled integration between public agencies in vocational rehabilitation. With the support of this law, coordination associations can be formed to fund and organize joint activities. The purpose of this study is to describe and analyze how the law has been interpreted and translated into local coordination associations and how local institutional logics have developed to guide the organization of these associations. Design/methodology/approach – Data was collected through observations of meetings within two coordination associations and supplemented with documents. The material was analyzed by compilation and examination of data from field notes, whereupon the most important aspects were crystallized and framed with institutional organization theory. Findings – Two different translations of the law were seen in the associations studied: the association as an independent actor, and as an arena for its member organizations. Two subsequent institutional logics have developed, influencing decisions on autonomy, objectives and rationality for initiating and organizing in the two associations and their activities. The institutional logics are circular, further enhancing the different translations creating different forms of integration. Research implications/limitations – Both forms of integration are legitimate, but the different translations have created integration with different degrees of autonomy in relation to the member organizations. Only a long-term analysis can show whether one form of integration is more functional than the other. Originality/value – This article is based on an extensive material providing insights into a form of interorganizational integration which has been scarcely researched. The findings show how different translations can influence the integration of welfare services.
|
|
| 3. |
- Andersson, Johanna, et al.
(author)
-
Integration in Vocational Rehabilitation : a Literature Review
- 2011
-
In: Integration inHealth and Healthcare.
-
Conference paper (other academic/artistic)abstract
- Context: With the increasing specialisation of services, integration has become important for health and other welfare organisations in order to address the complex problems of their patients or clients. This is particularly in care of the elderly, psychiatric care and vocational rehabilitation. The following presentation reports a review of literature on integration in vocational rehabilitation, focusing on models of integration as well as barriers and facilitators.Methods: The review was based on a search in scientific journals from 1995 to 2010. It generated 13132 articles, which were reduced to 1005 after an initial overview. The abstracts were read by members of the research group. Each abstract was read by two members independently. If they agreed the article was included or excluded, but if not the whole group discussed the abstract. This procedure reduced the number of articles to 205, which were read in full text. Finally, 62 articles were included for thematic content analysis.Results: Most of the studies came from Sweden, while others came from Canada, Australia, UK, Netherlands, Norway and Denmark. In these studies different models of integration were identified. They were classified as structural or process oriented. The structural models included case management, partnerships, co-location and financial coordination, while the process oriented models included informal contacts, interorganisational meetings and multidisciplinary teams. There were also a number of barriers as well as facilitators of integration. The barriers included structural and cultural differences, while communication, trust and continuity were important facilitators.Discussion: There are different models of integration, but also many combinations. Case management is often combined with interorganisational meetings or multidisciplinary teams. There are also informal contacts in all models. There is a clear mirror effect between the different barriers and facilitators. Leadership may be either a barrier or a facilitator. In the same way, differences between organisations may be both barriers and facilitators. These results seem to be valid also for other fields of integration, for example care of the elderly, psychiatric care, and other forms of community care.
|
|
| 4. |
- Andersson, Johanna, et al.
(author)
-
Organizational approaches to collaboration in vocational rehabilitation : an international literature review
- 2012
-
In: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 11, s. e137-
-
Journal article (peer-reviewed)abstract
- Introduction: Collaboration between welfare organizations is an important strategy for integrating different health and welfare services. This article reports a review of the international literature on vocational rehabilitation, focusing on different organizational models of collaboration as well as different barriers and facilitating factors.Methods: The review was based on an extensive search in scientific journals from 1995 to 2010, which generated more than 13,000 articles. The number of articles was reduced in different steps through a group procedure based on the abstracts. Finally, 205 articles were read in full text and 62 were included for content analysis.Results: Seven basic models of collaboration were identified in the literature. They had different degrees of complexity, intensity and formalization. They could also be combined in different ways. Several barriers and facilitators of collaboration were also identified. Most of these were related to factors as communication, trust and commitment.Conclusion: There is no optimal model of collaboration to be applied everywhere, but one model could be more appropriate than others in a certain context. More research is needed to compare different models and to see whether they are applicable also in other fields of collaboration inside or outside the welfare system.
|
|
| 5. |
- Andersson, Johanna, et al.
(author)
-
Organizational approaches to collaboration in vocational rehabilitation : An international literature review
- 2011
-
In: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 11
-
Journal article (peer-reviewed)abstract
- Introduction: Collaboration between welfare organizations is an important strategy for integrating different health and welfare services. This article reports a review of the international literature on vocational rehabilitation, focusing on different organizational models of collaboration as well as different barriers and facilitating factors. Methods: The review was based on an extensive search in scientific journals from 1995 to 2010, which generated more than 13,000 articles. The number of articles was reduced in different steps through a group procedure based on the abstracts. Finally, 205 articles were read in full text and 62 were included for content analysis. Results: Seven basic models of collaboration were identified in the literature. They had different degrees of complexity, intensity and formalization. They could also be combined in different ways. Several barriers and facilitators of collaboration were also identified. Most of these were related to factors as communication, trust and commitment. Conclusion: There is no optimal model of collaboration to be applied everywhere, but one model could be more appropriate than others in a certain context. More research is needed to compare different models and to see whether they are applicable also in other fields of collaboration inside or outside the welfare system.
|
|
| 6. |
- Andersson, J., et al.
(author)
-
Organizational approaches to collaboration in vocational rehabilitation-an international literature review
- 2012
-
In: International Journal of Integrated Care. - 1568-4156. ; 11
-
Journal article (peer-reviewed)abstract
- Introduction: Collaboration between welfare organizations is an important strategy for integrating different health and welfare services. This article reports a review of the international literature on vocational rehabilitation, focusing on different organizational models of collaboration as well as different barriers and facilitating factors. Methods: The review was based on an extensive search in scientific journals from 1995 to 2010, which generated more than 13,000 articles. The number of articles was reduced in different steps through a group procedure based on the abstracts. Finally, 205 articles were read in full text and 62 were included for content analysis. Results: Seven basic models of collaboration were identified in the literature. They had different degrees of complexity, intensity and formalization. They could also be combined in different ways. Several barriers and facilitators of collaboration were also identified. Most of these were related to factors as communication, trust and commitment. Conclusion: There is no optimal model of collaboration to be applied everywhere, but one model could be more appropriate than others in a certain context. More research is needed to compare different models and to see whether they are applicable also in other fields of collaboration inside or outside the welfare system.
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Eriksson, Andrea, 1977-, et al.
(author)
-
Collaboration in workplace health promotion : A case study
- 2012
-
In: International Journal of Workplace Health Management. - : Emerald Group Publishing Limited. - 1753-8351 .- 1753-836X. ; 5:3, s. 181-193
-
Journal article (peer-reviewed)abstract
- Purpose - The aim of this article is to describe and analyze a case of interorganizational and intersectoral collaboration on workplace health promotion involving nine municipalities in a Swedish region. Design/methodology/approach - A holistic case study design was chosen. The work of a project group responsible for developing plans for collaboration in the target area of health promoting leadership was studied. Observations at project meetings, interviews with project members, and written project documents were analyzed by qualitative methods. Findings - Collaboration on health promoting leadership was seen as a strategy to reduce the sickness rate among the employees in the municipalities. The best way to develop such leadership was considered to be through supporting good leadership in general and improving the general working conditions of managers in the municipalities. Moreover, it was regarded as a critical condition to have structural arrangements and resources to continue this collaboration. Practical implications - An implication of the study is that collaboration on workplace health promotion should be organized initially on a small scale, giving time and opportunities for the participants to develop mutual trust with one another. It is also important to involve participants with different knowledge and experiences in the field. Thus, it may be possible to develop strategies for health-promoting leadership contributing to the overall aim of a decreased sickness rate. Originality/value - There is limited research on barriers and facilitating factors for interorganizational and intersectoral collaboration on workplace health promotion. This study contributes an analysis of important conditions for this kind of collaboration.
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Eriksson, Andrea, 1977-, et al.
(author)
-
Implementation and Evaluation of Health Promoting Leadership
- 2010
-
In: Proceeding of the International Conference. ; , s. 28-33
-
Conference paper (peer-reviewed)abstract
- The evaluation of health-promoting workplaces is believed to form an integralpart of the planning and implementation of interventions. Recent approachesto workplace health promotion include how to organize work, andthe integration of health needs into management and leadership principles.The objective of this paper is to discuss the implementation and evaluationof interventions aimed at developing health-promoting leadership. Thepaper presents results from two case studies, the interventions of whichfocused on developing health-promoting leadership in Swedish municipalities.However, a wider participatory approach was lacking in both cases, andtherefore relevant courses of action for the specific workplaces were onlyidentified and addressed to a limited extent. In order to succeed with similarprogrammes it seems necessary to integrate health-promoting activitiesinto the daily work of managers, and to provide them with opportunities toinfluence environmental conditions of importance. The results show thatsuccessful interventions need to be adapted and integrated into the ongoingactivities and developments of the workplace. This paper will be presented apossible outline of the self-evaluation of health-promoting leadership.
|
|
| 14. |
- Åhgren, Bengt, et al.
(author)
-
Evaluating intersectoral collaboration : a model for assessment by service users
- 2009
-
In: International journal of integrated care. - 1568-4156. ; 9, s. e03-
-
Journal article (peer-reviewed)abstract
- INTRODUCTION: DELTA was launched as a project in 1997 to improve intersectoral collaboration in the rehabilitation field. In 2005 DELTA was transformed into a local association for financial co-ordination between the institutions involved. Based on a study of the DELTA service users, the purpose of this article is to develop and to validate a model that can be used to assess the integration of welfare services from the perspective of the service users.THEORY: The foundation of integration is a well functioning structure of integration. Without such structural conditions, it is difficult to develop a process of integration that combines the resources and competences of the collaborating organisations to create services advantageous for the service users. In this way, both the structure and the process will contribute to the outcome of integration.METHOD: The study was carried out as a retrospective cross-sectional survey during two weeks, including all the current service users of DELTA. The questionnaire contained 32 questions, which were derived from the theoretical framework and research on service users, capturing perceptions of integration structure, process and outcome. Ordinal scales and open questions where used for the assessment.RESULTS: The survey had a response rate of 82% and no serious biases of the results were detected. The study shows that the users of the rehabilitation services perceived the services as well integrated, relevant and adapted to their needs. The assessment model was tested for reliability and validity and a few modifications were suggested. Some key measurement themes were derived from the study.CONCLUSION: The model developed in this study is an important step towards an assessment of service integration from the perspective of the service users. It needs to be further refined, however, before it can be used in other evaluations of collaboration in the provision of integrated welfare services.
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
|
|
| 19. |
- Furenbäck, Ingela, 1963-
(author)
-
Utveckling av samverkan : ett deltagarorienterat aktionsforskningsprojekt inom hälso- och sjukvård
- 2012
-
Doctoral thesis (other academic/artistic)abstract
- Syfte: Det övergripande vetenskapliga syftet med denna avhandling att nå en ökad förståelse om samverkansprocesser.Ansats och metoder: Studien har bedrivits genom deltagarorienterad aktionsforskning inom hälso- och sjukvården i Hässleholm. Aktörer på verksamhetsfältet har strävat efter att utveckla samverkan för att tillsammans kunna utveckla närsjukvård. Forskningen har genererat kunskap utifrån lokala omständigheter att tjäna som underlag för beslut om att genomföra praktiska förändringar i verksamheten. En kombination av olika metoder har använts för att generera empiriskt material, där den huvudsakliga metoden har varit deltagande observationer med dialog. Därutöver har intervjuer och granskning av dokument använts samt en forskningscirkel, som är en speciell metod inom deltagarorienterad aktionsforskning. Studien har haft en hermeneutisk ansats och tolkningar har gjorts med stöd av olika teoretiska perspektiv och modeller. Kurt Lewins fältteori har utgjort en övergripande teoretisk ram för studien.Resultat: En ökad förståelse om den studerade samverkansprocessen kunde nås genom att beskriva och tolka skeenden som antogs ha påverkat utvecklingen av samverkan. Processen beskrevs både utifrån vertikal och horisontell integrering inom och mellan organisationer. Beskrivningen innefattade komponenter som fanns både inom arbetsprocesser och sociala processer. Den studerade samverkansprocessen delades in i delprocesser där var och en del innehöll en viss typ av aktivitet som genomfördes för att stödja utvecklingen av samverkan. Två olika strategier för utvecklingen av samverkan identifierades och illustrerades genom olika modeller: den linjära hierarkiska modellen respektive den dynamiska modellen. Den sistnämnda utvecklades genom aktionsforskningen.Slutsatser:I ett första skede bedrev deltagarna på fältet samverkan med stöd av den linjära hierarkiska modellen. Denna modell utgör ett tankeschema där samverkan utvecklas i en linjär hierarkisk process. Politiker fattar beslut, chefer planerar och professionella genomför aktiviteterna. Modellen utgår ifrån ett konsensusteoretiskt perspektiv där konflikter betraktas som störande element. Det innebar i detta fall att aktörer inom olika domäner och organisationer undvek varandras olika föreställningsvärldar varpå samverkansprocessen stötte på hinder i utvecklingen. Aktionsforskningen intervenerade i processen genom arrangera kommunikationsarenor med deltagare från olika domäner och organisationer. Samverkan utvecklades på så sätt utifrån den dynamiska modellen. Denna modell innehåller antaganden om att samverkansprocesser är dynamiska och har sin utgångspunkt i ett konfliktteoretiskt perspektiv där konflikter betraktas som naturliga i processen.
|
|
| 20. |
- Jansson von Vultée, Pia, et al.
(author)
-
Individual and Organizational Well-Being of Female Physicians : An Assessment of Three Different Management Programs
- 2004
-
In: Medscape General Medicine. - 1531-0132. ; 6:1
-
Journal article (peer-reviewed)abstract
- Abstract Management programs have become a popular method to develop future leaders. There is, however, a lack of controlled studies assessing the long-term effects of such programs on participants' career development, organizational influence, and mental and physical well-being. The aim of this prospective, controlled study was to assess the possible impact from 3 different structured management development programs on the individual and organizational well-being of female physicians. One year after the end of the 1-year intervention program, the intervention group reported statistically significant improvements in ratings of organizational influence, management feed back, perception of the organizational leadership, contact with one's immediate supervisor, and personal skills development as compared with the reference group. There were no statistically significant differences, however, between the groups with regard to individual health and well-being or career development. These results give rise to many questions, both concerning the effects of these 3 management programs and the career possibilities for female physicians.
|
|
| 21. |
- Jansson von Vultée, Pia, et al.
(author)
-
The impact of organisational settings on physician wellbeing
- 2007
-
In: International Journal of Health Care Quality Assurance. - : Emerald. - 0952-6862 .- 1758-6542. ; 20:6, s. 506-515
-
Journal article (peer-reviewed)abstract
- Purpose – The purpose of this research is to show that the Swedish health care system has undergone major changes during the last decades, which have exerted strong influence on the operational freedom of physicians. Design/methodology/approach – This study consisted of 169 physicians in management positions, who answered a questionnaire assessing the relationship between their organizational settings and their perceived wellbeing. The organizational setting was defined as contact with top management, decision-making influence, well defined organization and whether the physician is acting as a leader. The perceived wellbeing was defined as social climate, work related exhaustion, work satisfaction, influence, development ability and supportive leadership. Findings – According to the results, organizational support improves work satisfaction and mental energy, and decreases work related exhaustion among physicians. This all leads to decreasing turnover rate among physicians. Originality/value – These results point to the importance of maintaining a positive and supportive atmosphere for physicians in their work environment in order to encourage physicians to remain and take on management positions in the health care system. Furthermore enhancing physician influence over decision making processes is important to counteract work-related exhaustion and it might also contribute to a more efficient organization.
|
|
| 22. |
|
|
| 23. |
- Lindencrona, Fredrik, et al.
(author)
-
Modes of Interaction and Performance of Human Service Networks : A study of refugee resettlementsupport in Sweden
- 2009
-
In: Public Management Review. - 1471-9037 .- 1471-9045. ; 11:2, s. 191-215
-
Journal article (peer-reviewed)abstract
- Performance in health and human service networks requires mutual adjustment between participating organizations with different competencies. In this article the impact of group modes of interaction concerning administration and steering and direct service delivery upon different dimensions of network performance and client outcomes is tested in a sample of eighty-three local networks of refugee resettlement support in Sweden. The results show that networks with group modes of interaction concerning both issues generally perform best, but the effect varies across performance dimensions, is modified by availability of needed competence in the network and does not easily translate to client outcomes.
|
|
| 24. |
- Orvik, Arne, et al.
(author)
-
Organizational health in health organizations: Towards a conceptualization
- 2012
-
In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26, s. 796-802
-
Journal article (peer-reviewed)abstract
- This article is introducing a new concept of organizational health and discussing its possible implications for health organizations and health management. The concept is developed against the background of New Public Management, which has coincided with increasing workplace health problems in health organizations. It is based on research mainly in health promotion and health management. Organizational health is defined in terms of how an organization is able to deal with the tensions of diverse and competing values. This requires a dialectical perspective, integration as well as disintegration, and a tricultural approach to value tensions. The concept of organizational health is pointing towards an inverse value pyramid and a hybrid- and value-based form of management in health organizations. An application of this concept may clarify competing values and help managers to deal with the value tensions underlying workplace health problems on an organizational as well as an individual and group level. More empirical research is required, however, to link more closely the different aspects of organizational health in health organizations. © 2012 Nordic College of Caring Science.
|
|
| 25. |
- Rosengren, Kristina, 1963-
(author)
-
Hälso- och sjukvårdsorganisation i förändring : Från distanserat till delat ledarskap
- 2008
-
Doctoral thesis (other academic/artistic)abstract
- Syfte: Avhandlingen syftar till att följa upp, beskriva samt generera tentativ teori om pågående förändringsprocesser inom hälso- och sjukvården på såväl makronivå genom studier av sjukhusfusioner som mikronivå genom studier av delat ledarskap. Metod: ”Sjukhusfusioner” beskriver två genomförda sjukhussammanslagningar utifrån en kvalitativ ansats, Grounded Theory med intervjuer av vårdpersonal (I, II). ”Delat ledarskap” utgår från en förändrad ledarskapsmodell på en intensivvårdsavdelning med intervjuer (III-IV) samt frågeformulär (V) som datainsamlingsmetod. Vårdpersonalens uppfattningar av ledarskap redovisas genom en fenomenografisk ansats (III). Vidare beskrivs två avdelningschefers upplevelser av att ha arbetat i ett delat ledarskap genom Grounded Theory (IV). I den sista delstudien (V) används en kvantitativ metod i form av ett frågeformulär. En del av dessa frågor ingår i instrumentet QPSNordic som belyser vårdpersonalens åsikter om arbete, ledarskap och delat ledarskap. Resultat: Vårdpersonalen uttryckte behov av delaktighet och balans mellan olika behov och krav i ett förändringsarbete. Ledarskapets betydelse lyftes fram som en framgångsfaktor för att utveckla hälso- och sjukvårdsorganisationer i förändring. Vårdpersonalens idealbild av sjuksköterskans ledarskap utgjordes av en chef som var närvarande och tillgänglig i den dagliga verksamheten. Begreppet stödjande tvåsamhet lyftes fram som kärnan i delat ledarskap. Stödjande tvåsamhet, en tillitsfull relation mellan avdelningscheferna, bidrog till en god arbetsmiljö då ansvar och befogenheter delades av aktuellt ledarpar. Vårdpersonalen hade en positiv syn på sitt arbete och ledarskapet. De ansåg att det delade ledarskapet ökade avdelningschefernas möjligheter att vara engagerade och tillgängliga i det dagliga arbetet. Konklusion: Resultatet har bildat underlag för två empiriskt grundade modeller; engagerat ledarskap och stödjande tvåsamhet. Engagerat ledarskap utgår från begreppen delaktighet och stöd i en vårdande kultur. Stödjande tvåsamhet bygger på en gemensam värdegrund och olikheter i kompetens hos ledarparet som ligger till grund för utveckling av en tillitsfull relation. Vidare har teorin om det caritativa ledarskapet vidareutvecklats genom begreppet stödjande tvåsamhet som belyser relationen chef till chef i en vårdande kultur.
|
|
| 26. |
- Sandström, Ulla, et al.
(author)
-
Variation in views on clients in interprofessional work for vocational rehabilitation in Sweden
- 2007
-
In: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 21:5, s. 479-489
-
Journal article (peer-reviewed)abstract
- To deal with long-term sickness absence, inter-organizational and interprofessional projects for rehabilitation were established in Sweden in the late 1990s. This study explores the different views about the clients of such a project from the professionals of the organizations involved. Twenty-one key informants were interviewed in 1999 and 22 in 2002. The interviews were semi-structured and analysed with a phenomenographic approach. Four descriptive categories emerged: (A) the individual as consisting of components, (B) the individual in his/her context, (C) the individual as part of a group, and (D) the individual as part of the population. Category A included a paternalistic view and B included a maternalistic as well as an autonomous view. Both paternalism and maternalism imply an inequality in the relationship between the professional and the client. Category C had an organizational perspective, whereas category D had a community perspective. Both of these perspectives included an abstract view of the client. The conclusions were that the professionals had qualitatively different views on clients, which might lead to unequal encounters as well as differences in opportunities for rehabilitation. The results stress the importance of discussing what ethical values are desirable, not least in inter-organizational and interprofessional projects.
|
|
| 27. |
|
|
| 28. |
- Wihlman, Ulla, et al.
(author)
-
Barriers of inter-organisational integration in vocational rehabilitation
- 2008
-
In: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 19:8, s. 1-12
-
Journal article (peer-reviewed)abstract
- INTRODUCTION: A project of vocational rehabilitation was studied in Sweden between 1999 and 2002. The project included four public organisations: the social insurance office, the local health services, the municipal social service and the office of the state employment service. The aim of this paper was to analyse perceived barriers in the development of inter-organisational integration. THEORY: Theories of inter-professional and inter-organisational integration, and theories on organisational change. METHODS: In total, 51 semi-structured interviews and 14 focus group discussions were performed with actors within the project between 1999 and 2002. A thematic approach was used for the analysis of the data. RESULTS: THREE DIFFERENT MAIN THEMES OF BARRIERS EMERGED FROM THE DATA: A Uncertainty, B Prioritising own organisation and C Lack of communication. The themes are interconnected in an intricate web and hence not mutually exclusive. CONCLUSIONS AND DISCUSSION: The barriers found are all related partly to organisational change in general and partly to the specific development of organisational integration. Prioritising of own organisation led to flaws in communication, which in turn led to a high degree of uncertainty within the project. This can be seen as a circular relationship, since uncertainty might increase focus on own organisation and lack of communication. A way to overcome these barriers would be to take the needs of the clients as a point of departure in the development of joint services and to also involve them in the development of inter-organisational integration.
|
|
| 29. |
- Wihlman, Ulla, et al.
(author)
-
Organizing vocational rehabilitation through interorganizational integration : a case study in Sweden
- 2011
-
In: International Journal of Health Planning and Management. - : Wiley. - 0749-6753 .- 1099-1751. ; 26:3, s. E169-E185
-
Journal article (peer-reviewed)abstract
- This study describes and analysis five years of experiences from organising an interorganisational project on vocational rehabilitation. A qualitative case study approach was used based on interviews, focus group discussions and documents. The aim was to analyse how and why the project was organised in the way it was in relation to theories of integration, organisational change and learning. The results show that the vocational rehabilitation project was initiated mainly for financial reasons. It was organised as a mechanistic system with the aim of producing different activities, where financial control and support from all the levels of the organisations involved was important. A new bureaucracy between the different authorities involved was built up, where the vertical (top-down) integration was more important than the horizontal. The result was scattered islands of interprofessional work in different teams, but without contacts between them. The project did not influence the processes or workflows of the organisations involved in the project, which would be important from a service-user perspective. It may therefore be questionnable to organise the development of interorganisational integration for vocational rehabilitation in a separate project organisation. Instead, interorganisational networks with focus on interconnections of processes and workflows may be more flexible and adaptable. Copyright (C) 2010 John Wiley & Sons, Ltd.
|
|
| 30. |
- Åhgren, Bengt, et al.
(author)
-
Determinants of integrated health care development : chains of care in Sweden
- 2007
-
In: International Journal of Health Planning and Management. - 0749-6753 .- 1099-1751. ; 22:2, s. 145-157
-
Journal article (peer-reviewed)abstract
- Local health care in Sweden is an emerging form of integrated care, linked together by chains of care. Experiences show, however, that the development of chains of care is making slow progress. In order to study the factors behind this development, an embedded multiple-case study design was chosen. The study compared six health authorities in Sweden, three with successful and three with unsuccessful chain of care development. Three major determinants of integrated health care development were identified: professional dedication, legitimacy and confidence. In more detail, space for prime movers and trust between participants were crucial success factors, while top-down approaches targeting at the same time a change of management systems were negative for the development of chains of care. Resistance from the body of physicians was a serious obstacle to such a development. Local health care depends on developed chains of care, but it seems that health care managers do not have the management systems necessary to run these clinical networks, mainly due to a lack of acceptance from the medical profession. This is an impossible situation in the long run, since the number of chains of care is likely to increase as a result of the emerging local health care. Copyright (c) 2007 John Wiley & Sons, Ltd.
|
|
| 31. |
- Åhgren, Bengt, et al.
(author)
-
Evaluating integrated health care : a model for measurement
- 2005
-
In: International journal of integrated care. - 1568-4156. ; 5:Jul-Sep, s. e01-
-
Journal article (peer-reviewed)abstract
- PURPOSE: In the development of integrated care, there is an increasing need for knowledge about the actual degree of integration between different providers of health services. The purpose of this article is to describe the conceptualisation and validation of a practical model for measurement, which can be used by managers to implement and sustain integrated care.THEORY: The model is based on a continuum of integration, extending from full segregation through intermediate forms of linkage, coordination and cooperation to full integration.METHODS: The continuum was operationalised into a ratio scale of functional clinical integration. This scale was used in an explorative study of a local health authority in Sweden. Data on integration were collected in self-assessment forms together with estimated ranks of optimum integration between the different units of the health authority. The data were processed with statistical methods and the results were discussed with the managers concerned.RESULTS: Judging from this explorative study, it seems that the model of measurement collects reliable and valid data of functional clinical integration in local health care. The model was also regarded as a useful instrument for managers of integrated care.DISCUSSION: One of the main advantages with the model is that it includes optimum ranks of integration beside actual ranks. The optimum integration rank between two units is depending on the needs of both differentiation and integration.
|
|
| 32. |
- Åhgren, Bengt, 1950-, et al.
(author)
-
Integrated Care : Pathfindings from Sweden
- 2013
-
In: Integrated care for Ireland in an international context. - Cork, Ireland : Oak Tree Press. - 9781781190807 - 1781190801 - 9781781191040 - 1781191042 ; , s. 90-102
-
Book chapter (other academic/artistic)
|
|
| 33. |
|
|
| 34. |
- Åhgren, Bengt
(author)
-
Utvärdering av integration inom närsjukvård
- 2007
-
In: Folkhälsa i samverkan mellan professioner, organisationer och samhällssektorer. - Malmö : Studentlitteratur AB. ; , s. 305-321
-
Book chapter (other academic/artistic)
|
|
