| 1. |
- Ekman, Björn, et al.
(författare)
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Skala upp den befintliga digitala vården i Sverige
- 2020
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Ingår i: Dagens Medicin. - Stockholm : Bonnier. - 1104-7488.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Ge Socialstyrelsen ett nationellt uppdrag att beställa och ersätta vårdgivare av digital vård, föreslår en grupp forskare med anledning av covid-19.
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| 2. |
- Hägglund, Maria, Lektor, 1975-, et al.
(författare)
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Escape to the future : a qualitative study of physicians' views on the work environment, education, and support in a digital context
- 2023
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Ingår i: BMC Medical Informatics and Decision Making. - : BioMed Central (BMC). - 1472-6947. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe use of remote services such as video consultations (VCs) has increased significantly in the wake of the COVID-19 pandemic. In Sweden, private healthcare providers offering VCs have grown substantially since 2016 and have been controversial. Few studies have focused on physicians’ experiences providing care in this context. Our aim was to study physicians’ experiences of VCs, focusing on the work environment, quality of care, and educational needs.MethodsTwenty-two semi-structured interviews were performed with physicians working with VCs in Sweden, and analyzed through inductive content analysis.ResultsWe identified five categories; flexibility, social work environment, impact on care and society, continuous learning and career development, and organizational support. Flexibility and accessibility were considered positive features of working digitally by giving physicians control over their time and workplace and increasing patients’ timely access to healthcare. Regarding collegial contact and social activities in a digital context, the majority of the participants did not experience any significant difference compared to the physical context. Access to technical support services, educational support, and collegial support in decision-making, guidance, and consultations were described as well-functioning. Satisfied patients positively impacted the work environment, and participants felt that VCs have a positive socio-economic effect. Continuity of care was considered supported, but patients did not always prioritize this. Privacy risks were considered a challenge, as were poor development of clinical skills due to the low variation of patient cases. Working for an online healthcare provider was contributing to career advancements for junior clinicians.ConclusionsPhysicians appreciate the flexibility of the digital context and seem satisfied with a work environment where they have a high level of control, but few consider this a full-time career option. The pandemic year 2020 has led to a significant increase in the implementation of VCs in traditional care systems. How this affects the work environment and continuous education needs and career development remains to be seen.
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| 3. |
- Hägglund, Maria, Lektor, 1975-, et al.
(författare)
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The Future of Online Video Consultations in Primary Care : A Qualitative Study
- 2023
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Ingår i: Caring is Sharing - Exploiting the Value in Data for Health and Innovation - Proceedings of MIE 2023. - : IOS Press. - 0926-9630 .- 1879-8365. - 9781643683881 - 9781643683898 ; 302, s. 942-946
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Konferensbidrag (refereegranskat)abstract
- The COVID-19 pandemic has significantly increased the use of remote services such as video consultations (VCs). In Sweden, private healthcare providers offering VCs have grown substantially since 2016 and have been controversial. Few studies have focused on physicians' experiences of providing care in this context. Our overall aim was to study physicians' experiences of VCs, here focusing on their suggestions for future improvements. Twenty-two semi-structured interviews were performed with physicians working for an online healthcare provider in Sweden, and analyzed through inductive content analysis. Two themes emerged related to desired future improvements of VCs; blended care and technical innovation.
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| 4. |
- Liu, Jenny, et al.
(författare)
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Can dedicated emergency team and area for older people reduce the hospital admission rate? : An observational pre- and post-intervention study
- 2021
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318 .- 1471-2318. ; 21:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundEmergency department (ED) care of older patients is often complex. Geriatric ED guidelines can help to meet this challenge. However, training requirements, the use of time-consuming tools for comprehensive geriatric assessment (CGA), a lack of golden standard to identify the frail patients, and the weak evidence of positive outcomes of using CGA in EDs pose barriers to introduce the guidelines. Dedicating an interprofessional team of regular ED medical and nursing staff and an older-friendly ED area can be another approach. Previous studies of geriatrician-led CGA in EDs have reported a reduced hospital admission rate. The aim of this study was to investigate whether a dedicated interprofessional emergency team also can reduce the hospital admission rate without the resources required by the formal use of CGA.MethodsAn observational pre-post study at a large adult ED, where all patients 80years or older arriving on weekdays in the intervention period from 2016.09.26 to 2016.11.28 and the corresponding weekdays in the previous year from 2015.09.28 to 2015.11.30 were included.In the intervention period, older patients either received care in the geriatric module by the dedicated team or in the regular team modules for patients of mixed ages. In 2015, all patients received care in regular team modules. The primary outcome measure was the total hospital admission rate and the ED length of stay was the secondary outcome measure.ResultsWe included 2377 arrivals in the intervention period, when 26.7% (N=634) received care in the geriatric module, and 2207 arrivals in the 2015 period. The total hospital admission rate was 61.7% (N=1466/2377) in the intervention period compared to 64.8% (N=1431/2207) in 2015 (p=0.03). The difference was larger for patients treated in the geriatric module, 51.1% compared to 62.1% (95% CI: 56.3 to 68.0%) for patients who would have been eligible in 2015. The ED length of stay was longer in the intervention period.ConclusionsAn interprofessional team and area dedicated to older patients was associated to a lower hospital admission rate. Further studies are needed to confirm the results.
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| 5. |
- Liu, Jenny, et al.
(författare)
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Evaluation of interprofessional teamwork modules implementation in an emergency department : A mixed-methods case study of implementation fidelity
- 2021
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The need for interprofessional collaboration has been emphasized by health organizations. This study was part of a mixed-methods evaluation of interprofessional teamwork modules implementation in an emergency department (ED), where a major intervention was didactic training of team roles and behaviours in combination with practice scenarios. The aim of the study was to evaluate the implementation of interprofessional teamwork modules from a staff perspective and focus on how implementation fidelity may be sustained. Methods In this mixed-methods case study we triangulated staff data from structured observations, semi-structured interviews, and a questionnaire repeated at intervals over 5 years. A protocol of key team behaviours was used for the observations conducted in June 2016 and June 2018, 11/2 and 31/2 years after the initial implementation. A purposeful sample of central informants, including nursing and medical professionals and section managers, was interviewed from May to June 2018. The interview guide consisted of open-ended questions about the experiences of interprofessional teamwork modules and the implementation process. The questionnaire consisted of five statements about the perceived workload, interprofessional collaboration and patient satisfaction, where each was rated on a Likert scale. Results Good fidelity to four out of five key team behaviours was observed during the first year. However, fidelity was sustained only for one key team behaviour after 3 years. We conducted a qualitative content analysis of 18 individual interviews. The theme Enjoying working together, but feeling less efficient emerged of the interprofessional teamwork modules, despite shorter ED stays for the patients. Negative experiences of the staff included passive team leaders and slow care teams. The theme Stimulating to create, but challenging to sustain emerged of the implementation process, where barriers were not adressed and implementation fidelity not sustained. The staff questionnaire showed that the perceived work conditions was improved in periods of high fidelity, but deteriorated to pre-implementation levels as fidelity to the key team behaviours decayed in 2018. Conclusions Extensive planning and successful initial implementation were not enough to sustain the key behaviour changes in the study. The use of implementation frameworks can be helpful in future projects.
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| 6. |
- Söderberg, Daniel, et al.
(författare)
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Individual Patient Factors Associated with the Use of Physical or Digital Primary Care in Sweden
- 2024
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Ingår i: Telemedicine journal and e-health. - : Mary Ann Liebert, Inc., publishers. - 1530-5627 .- 1556-3669.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Little is known about factors that influence patients' choice to use physical or digital primary care. This study aimed to compare self-rated health, internet habits, and what patients deem important when choosing health care between users of physical and digital primary health care. Methods: We recruited 2,716 adults visiting one of six physical or four digital primary health care providers in Stockholm, Sweden, October 2020 to May 2021. Participants answered a questionnaire with questions about sociodemography, self-rated health, internet habits, and what they considered important when seeking care. We used logistic regression and estimated odds ratios (ORs) for choosing digital care. Results: Digital users considered themselves healthier and used the internet more, compared with physical users (p < 0.001). Competence of health care staff was the most important factor when seeking care to both physical and digital users (90% and 78%, respectively). Patients considering it important to avoid leaving home were more likely to seek digital care (OR 29.55, 95% confidence interval [CI] 12.65?69.06), while patients valuing continuity were more likely to seek physical care (OR 0.25, 95% CI 0.19?0.32). These factors were significant also when adjusting for self-rated health and sociodemographic characteristics. Conclusion: What patients considered important when seeking health care was associated with what type of care they sought. Patient preferences should be considered when planning health care to optimize resource allocation.
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