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- Ekstedt, Mirjam, Professor, et al.
(författare)
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Patient safety and sense of security when telemonitoring chronic conditions at home: the views of patients and healthcare professionals : a qualitative study
- 2023
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic diseases are increasing worldwide, and the complexity of disease management is putting new demands on safe healthcare. Telemonitoring technology has the potential to improve self-care management with the support of healthcare professionals for people with chronic diseases living at home. Patient safety threats related to telemonitoring and how they may affect patients’ and healthcare professionals’ sense of security need attention. This study aimed to explore patients’ and healthcare professionals’ experiences of safety and sense of security when using telemonitoring of chronic conditions at home.Methods: Semi-structured interviews were conducted with twenty patients and nine healthcare professionals (nurses and physicians), recruited from four primary healthcare centers and one medical department in a region in southern Sweden using telemonitoring service for chronic conditions in home healthcare.Results: The main theme was that experiences of safety and a sense of security were intertwined and relied on patients´ and healthcare professionals´ mutual engagement in telemonitoring and managing symptoms together. Telemonitoring was perceived to increase symptom awareness and promote early detection of deterioration promoting patient safety. A sense of security emerged through having someone keeping track of symptoms and comprised aspects of availability, shared responsibility, technical confidence, and empowering patients in self-management. The meeting with technology changed healthcare professionals’ work processes, and patients’ daily routines, creating patient safety risks if combined with low health- and digital literacy and a naïve reliance on technology. Empowering patients’ self-management ability and improving shared understanding of the patient’s health status and symptom management were prerequisites for safe care and the patient´s sense of security.Conclusions: Telemonitoring chronic conditions in the homecare context can promote a sense of security when care is co-created in a mutual understanding and responsibility. Attentiveness to the patient’s health literacy, symptom management, and health-related safety behavior when using eHealth technology may enlighten and mitigate latent patient safety risks. A systems approach indicates that patient safety risks related to telemonitoring are not only associated with the patient’s and healthcare professionals functioning and behavior or the human-technology interaction. Mitigating patient safety risks are likely also dependent on the complex management of home health and social care service.
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| 3. |
- Hedqvist, Ann-Therese, Doktorand, et al.
(författare)
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In pursuit of integrated care : Interprofessional collaboration in transitional care for older people with complex care needs
- 2023
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Ingår i: Presented at the Nordic Conference in Nursing Research, Reykjavik, Iceland, October 2-4, 2023.
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Konferensbidrag (refereegranskat)abstract
- Background:Contemporary healthcare systems are based on a reductionist, biomedical paradigm maladapted to meet the needs of an aging population with multimorbidity. Integrated care and interprofessional collaboration are suggested to connect the different parts of healthcare. However, how this can be realised is less understood.The aim of the study was to develop a deeper understanding of how interprofessional collaboration across care providers in transitional care is conducted to achieve integrated care for older people with complex care needs.Method:Using constructivist grounded theory, observations and interviews were conducted with healthcare and social care professionals (n=86) from a multidisciplinary and cross-stakeholder perspective in a region in Sweden.Results:Interprofessional collaboration in transitional care emerges as a continuum of "Moving from fragmentation to coupling and integration through collaborative efforts". On the lowest level of integration, professionals are working in organisational “silos” that are difficult to cross, as each specialist's expert knowledge is necessary for the vulnerable patient´s wellbeing. Patients´ perception of seamless care is facilitated by the mutual sharing of patient data across organizations through integrated information systems. The highest level of integration is consolidated as the interprofessional team collaborates on a pronounced common ground with a shared mental map of the goals of care, constructing unity for the older person and their family.Conclusion:To achieve seamless transitional care for older people with complex care needs, clear boundaries and liability areas are necessary, and actors in interprofessional teams are required to assume responsibility across conceivable gaps across organizations.
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| 4. |
- Svensson, Ingrid, et al.
(författare)
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Unfolding alignment - How top management work to align demand and capacity : an ethnographic study of resilience in a Swedish healthcare region.
- 2023
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Resilient healthcare organizations maintain critical functions and high-quality care under varying conditions. While previous research has focused on the activities of frontline healthcare professionals working at the "sharp end" of care, less attention has been paid to managers at the top management level. More knowledge is needed to fully understand how the managers align demand and capacity at the "blunt end" of care. Therefore, this study aimed to explore how top managers work to align demand and capacity in a healthcare region in Sweden.METHODS: Observations of management team meetings, interviews, and conversations were conducted with top managers responsible for healthcare in one of Sweden's 21 regions. Data collection used an ethnographic approach. Data were analyzed using qualitative reflexive thematic analysis.RESULTS: The data showed how alignment work was done through active reflection that built on past experiences and on structures built into the organization at the same time as taking future potential outcomes and consequences into account. In addition to collaborative, preventive, supportive, and contextualizing work, which was conducted in the present, a general approach permeated the organization, which enabled connecting actions, i.e., different forms of alignment work, occurring at different points in time, and connecting different types of knowledge across organizational borders and stakeholders.CONCLUSION: This study explored how top managers work to align demand and capacity in a healthcare region in Sweden. It was shown how four categories of work; collaborative, preventive, supportive and contextualization work, together with a general approach; focusing on opportunities, building on a stable past and taking a reflective stance, constitute alignment in practice. More; the alignment work was done in the here and now, with both the past and future in mind. The ability to take action to benefit the whole is a possibility and a responsibility for top management. In the region studied, this was done by aligning demands with capacity based on past experiences and focusing on the available opportunities to connect knowledge needed within and across organizational borders.
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