| 1. |
- Abrahamsson, Agneta, 1951-, et al.
(författare)
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Open pre-schools at integrated health services : a program theory
- 2013
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Ingår i: International Journal for Integrated Care. - 1568-4156. ; 13, s. e014-
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres.Method: A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre.Findings: The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents. Conclusion: The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.
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| 2. |
- Abrahamsson, Agneta, et al.
(författare)
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Open pre-schools at integrated health services : a program theory
- 2013
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Ingår i: International Journal for Integrated Care. - 1568-4156. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres. Method: A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre. Findings: The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents. Conclusion: The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.
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| 3. |
- Agerholm, Janne, et al.
(författare)
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Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County : An Interrupted Time Series Analysis
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 21:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtälje on the rate of admissions for ambulatory care sensitive conditions (ACSC).Method: Using interrupted time series analyses we investigated the effect of implementing IC in Norrtälje municipality in the northern part of Stockholm county, Sweden. The time period included 48 time points, from year 2000 to year 2011 with measurements before and after introducing IC in Norrtälje in 2006. In order to control for other extraneous events that could affect the outcome measure, but not related to the introduction of IC, we included a control population from Stockholm municipality.Results: After introducing IC in Norrtälje the rate of admissions for ACSC decreased. This decrease was greater in Norrtälje than in the matched control population, however the difference between the two areas was not statistically significant (p = 0.08).Conclusion: Introducing IC in Norrtälje may have had positive impact on admissions for ACSC for older people living in Norrtälje; however, the interpretation of the impact of IC on admissions for ACSC is complicated by intervening policy changes in health and social care during the study period.
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| 4. |
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| 5. |
- Aidemark, Jan, 1967-, et al.
(författare)
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Barriers to adoption of eHealth solutions based on research project result
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:S1
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Tidskriftsartikel (refereegranskat)abstract
- ICT projects, development and/or research driven, are sources of new innovative eHealth solutions. However, the rate of continued use is low and gaining sustainable benefits in daily operations is difficult (Warth et al.). This research looks at the barriers for the organizational implementation based on research driven projects. Three eHealth projects have been analyzed for aspects on the phenomenon, to gain a deeper understanding of the problem. Results are based on discussions between project participants, (professionals, decision makers, patients), and analysis of the project set ups and purposes. ResultsFactors that could be seen as important for lack of continued use includes: pure research setup of projects, lack of financial resources in the post projects time , lack of organizational competences for adoption of solutions, no organizational champion or CEO support, lack of fit to organizational processes or scheduling, professional resistance to change, among others. DiscussionProject set ups and working methods of the project might hamper the possibilities of effective knowledge transfer and organizational adoption. Experiences from mentioned projects show that a 360-degree co-design approach, which includes major stakeholder (for example, professionals, patients, researchers, patients, decisions makers) should be included. There is a need to prepare for knowledge transfer processes in post project phases, including competence development strategies for professionals and organizational change plans. Conclusions A holistic understanding of conditions and challenges is needed for paving the way for health organization to reap benefits from research projects. Lessons learned Projects need to include processes for engaging the stakeholders through 360 co-design, knowledge transfer plans and competence development strategies. Limitations The research is exploratory and based on analysis of past and ongoing eHealth projects. Suggestions for future researchBetter understanding for how to integrating competence development and organizational change as a part of eHealth project are needed. An investigation on digital competence among patients and healthcare personnel is planned, with the purpose of defining competence development strategies and requirements for IT-enabled cooperation and co-production.
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| 6. |
- Aidemark, Jan, 1967-, et al.
(författare)
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Co-designing self-care solutions with elderly : lessons learnt
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 20:S1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Ehealth solutions are in great need in the community of elderly in general, as patients or home carers, however a design approach that delivers this is illusive. In this research we present the experiences from a set of design processes targeting elderly’s needs of support or home care, based on a co-design approach. The purpose is to present guiding principles for how to work with elderly in a co-design process, to be used as basis for future set up of co-design processes.
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| 7. |
- Aidemark, Jan, 1967-, et al.
(författare)
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ICT challenges of Integrated care from a Co Design perspective using a Quadraple Helix
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 20:S1
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Tidskriftsartikel (refereegranskat)abstract
- The Internet of Things (IoT) plays a vital role in today’s medicine (Islam et al, 2015). In 2020, 40% of IoT-related technologies will be assigned to the health domain, which makes up around a 117 $ billion in the global market (Bauer, Patel & Veira, 2016). Adding to this the demographic changes will further set a significant challenge in Europe (Steinführer & Haase, 2007). Innovative techniques for supporting health systems and independent life for the aging population is therefore essential, not at least in relation to fall prevention and technology for promoting a good life throughout the lifespan. Further, participation from patients is a goal for healthcare worldwide (Lundgren, Sunesson & Tunved, 2014). For example according to the Health and Medical care act in Sweden (1982:763) it is described that the goal for health care “is good health and care on equal terms for the entire population”. In line with this challenge of integrated care the patient itself will be the most important resource for promotion of health, why Co Design is needed as a method for innovation in healthcare sector. It is important for the users ‘experiences and insights to contribution in improvements but not at least because it has been shown that increased involvement with the user in care reduces the number of hospital visits (Simpsons, 2007).
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| 8. |
- Andersson Bäck, Monica, 1969, et al.
(författare)
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The Norrtaelje model: a unique model for integrated health and social care in Sweden
- 2015
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Ingår i: International Journal of Integrated Care. - 1568-4156. ; 15:Special Issue: SI, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Many countries organise and fund health and social care separately. The Norrtaelje model is a Swedish initiative that transformed the funding and organisation of health and social care in order to better integrate care for older people with complex needs. In Norrtaelje model, this transformation made it possible to bringing the team together, to transfer responsibility to different providers, to use care coordinators, and to develop integrated pathways and plans around transitions in and out of hospital and from nursing homes to hospital. The Norrtaelje model operates in the context of the Swedish commitment to universal coverage and public programmes based on tax-funded resources that are pooled and redistributed to citizens on the basis of need. The experience of Norrtaelje model suggests that one way to promote integration of health and social care is to start with a transformation that aligns these two sectors in terms of high level organisation and funding. This transformation then enables the changes in operations and management that can be translated into changes in care delivery. This “top-down” approach must be in-line with national priorities and policies but ultimately is successful only if the culture, resource allocation and management are changed throughout the local system.
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| 9. |
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| 10. |
- Andersson, Johanna, et al.
(författare)
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Organizational approaches to collaboration in vocational rehabilitation : an international literature review
- 2012
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Ingår i: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 11, s. e137-
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Tidskriftsartikel (refereegranskat)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.
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| 11. |
- Andersson, Johanna, et al.
(författare)
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Organizational approaches to collaboration in vocational rehabilitation : An international literature review
- 2011
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Ingår i: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 11
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Tidskriftsartikel (refereegranskat)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.
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| 12. |
- Andersson, J., et al.
(författare)
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Organizational approaches to collaboration in vocational rehabilitation-an international literature review
- 2012
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Ingår i: International Journal of Integrated Care. - 1568-4156. ; 11
-
Tidskriftsartikel (refereegranskat)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.
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| 13. |
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| 14. |
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| 15. |
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| 16. |
- Berglund, Helene, 1957, et al.
(författare)
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Care planning at home: a way to increase the influence of older people?
- 2012
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Ingår i: International Journal of Integrated Care. - : Igitur, Utrecht Publishing & Archiving Services. - 1568-4156. ; 12:September
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Care-planning meetings represent a common method of needs assessment and decision-making practices in elderly care. Older people's influence is an important and required aspect of these practices. This study's objective was to describe and analyse older people's influence on care-planning meetings at home and in hospital. Methods: Ten care-planning meetings were audio-recorded in the older people's homes and nine were recorded in hospital. The study is part of a project including a comprehensive continuum-of-care model. A qualitative content analysis was performed. Results: Care-planning meetings at home appeared to enable older people's involvement in the discussions. Fewer people participated in the meetings at home and there was less parallel talking. Unrelated to the place of the care-planning meeting, the older people were able to influence concerns relating to the amount of care/service and the choice of provider. However, they were not able to influence the way the help should be provided or organised. Conclusion: Planning care at home indicated an increase in involvement on the part of the older people, but this does not appear to be enough to obtain any real influence. Our findings call for attention to be paid to older people's opportunities to receive care and services according to their individual needs and their potential for influencing their day-to-day provision of care and service.
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| 17. |
- Bergmark, Magnus, et al.
(författare)
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Complex Interventions and Interorganisational Relationships : Examining Core Implementation Components of Assertive Community Treatment
- 2018
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156 .- 1568-4156. ; 18:4, s. 1-11
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: There is increasing interest in implementing evidence-based integrated models of care in community-based mental health service systems. Assertive Community Treatment (ACT) is seen as an attractive, and at the same time challenging, model to implement in sectored service settings. This study investigates the implementation process of such an initiative.Methods: Interviews were conducted with ACT team members, the process leader, steering group members, and collaboration partners. The “Sustainable Implementation Scale” helped to identify critical implementation components, and these were further explored using the qualitative interview data. The “Tool for Measuring Assertive Community Treatment” addressed programme fidelity, and the initiative’s sustainability was assessed.Results: High-fidelity implementation of ACT in a sectored service setting is possible. Prominent components that facilitated implementation were careful preparations, team members’ characteristics, and efforts by the process leader and the steering group to improve networking. Implementation was hampered by conflicting goals among the involved authorities and a mismatch between the ACT model’s characteristics and existing organisational traditions and regulations.Discussion and Conclusions: Reducing the uncertainty caused by conflicting goals is an important step in improving the implementation of ACT. In order to facilitate implementation, the goals, regulations, and availability of resources should be aligned horizontally and vertically through the involved organisations.
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| 18. |
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| 19. |
- Bångsbo, Angela, 1968, et al.
(författare)
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Barriers for Inter-Organisational Collaboration: What Matters for an Integrated Care Programme?
- 2022
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 22:22
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Inter-organisational collaboration is challenging but essential in managing the complex and comprehensive needs of frail older people. Therefore, there is a need to investigate the influence of different barriers to inter-organisational collaboration when implementing an integrated care programme. The aim of this study was to investigate both inpatient and outpatient staff views on the factors they deemed to be influential to inter-organisational collaboration for an integrated care programme. Methods: The study was a cross-sectional study and included staff from hospitals, primary care and municipal health and social care. Results: There were no significant differences between staff from inpatient and outpatient care in measuring factors that may cause difficulties for inter-organisational collaboration. Staff views diverged significantly on all factors, such as educational level at long physical distances, laws and regulations, knowledge of each others work settings, experience from inter-organisational collaboration, different professions, variations in professional status and power, psychosocial factors such as positive work environment and interpersonal chemistry. Discussion: A multidisciplinary team culture and avenues for inter-organisational collaboration need to be developed for improved care continuity. Conclusion: The staffs’ educational level influenced what was perceived as barriers to inter-organisational collaboration, and may guide future development of integrated care programmes.
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| 20. |
- Bångsbo, Angela, et al.
(författare)
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Patient participation in discharge planning conference
- 2014
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 14, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: There is a need for individualized discharge planning to support frail older persons at hospital discharge. In this context, active participation on their behalf cannot be taken for granted. The aim of this study was to elucidate patient participation in discharge planning conferences, with a focus on frail older persons, supported by the theory of positioning described by Harré & van Langenhove. Methods: The study was designed as a case study based on audio-recordings of multidisciplinary discharge planning conferences and interviews with health professionals elucidating their opinions on preconditions for patient participation in discharge planning. The analysis has been performed using qualitative content analysis and discourse analysis. Data collection took place during 2008–2009 and included 40 health professionals and 13 frail older persons in hospital or municipal settings. Results: Findings revealed four different positions of participation, characterized by the older person’s level of activity during the conference and his/her appearance as being reduced (patient) or whole (person). The positions varied dynamically from being an active person, passive person, active patient, or passive patient and the health professionals, next-of-kin, and the older persons themselves contributed to the positioning. Conclusions: The findings showed how the institutional setting served as a purposeful structure or a confinement to patient participation.
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| 21. |
- Bångsbo, Angela, 1968, et al.
(författare)
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Patient participation in discharge planning conference.
- 2014
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Ingår i: International journal of integrated care. - 1568-4156. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- There is a need for individualized discharge planning to support frail older persons at hospital discharge. In this context, active participation on their behalf cannot be taken for granted. The aim of this study was to elucidate patient participation in discharge planning conferences, with a focus on frail older persons, supported by the theory of positioning described by Harré & van Langenhove.
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| 22. |
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| 23. |
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| 24. |
- Davoody, Nadia, et al.
(författare)
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Collaborative interaction points in post-discharge stroke care.
- 2014
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Lack of appropriate electronic tools for supporting patient involvement and collaboration with care professionals is a problem in health care.METHODS: Care and rehabilitation processes of post-discharge stroke patients were analysed using the concept of interaction points where patients, next-of-kin and care professionals interact and exchange information. Thirteen interviews with care professionals and five non-participatory observations were performed. Data were analysed using content analysis and modelling of interaction points in the patient journey.RESULTS: Patient participation and interaction patterns vary; patients requiring home care have a passive role and next-of-kin or nurses become advocates by coordinating care on behalf of the patient, whereas patients who are able to visit primary care coordinate their own care by initiating interactions. Important categories of participation include the following: participation in care planning, in monitoring risk factors and in rehabilitation planning.CONCLUSIONS: Designing a supportive electronic tool requires understanding the interactions and patients' activity levels at each interaction point. A tool for patients with higher activity level should support them to coordinate their own care, whereas for a less-active patient group, the tool could focus on supporting next-of-kin and care professionals in motivating, guiding and including passive patients in their care and rehabilitation processes.
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| 25. |
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| 26. |
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| 27. |
- Dunér, Anna, 1962, et al.
(författare)
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Implementing a continuum of care model for older people - results from a Swedish case study
- 2011
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 11:October-December
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: There is a need for integrated care and smooth collaboration between care-providing organisations and professions to create a continuum of care for frail older people. However, collaboration between organisations and professions is often problematic. The aim of this study was to examine the process of implementing a new continuum of care model in a complex organisational context, and illuminate some of the challenges involved. The introduced model strived to connect three organisations responsible for delivering health and social care to older people: the regional hospital, primary health care and municipal eldercare. Methods: The actions of the actors involved in the process of implementing the model were understood to be shaped by the actors' understanding, commitment and ability. This article is based on 44 qualitative interviews performed on four occasions with 26 key actors at three organisational levels within these three organisations. Results and conclusions: The results point to the importance of paying regard to the different cultures of the organisations when implementing a new model. The role of upper management emerged as very important. Furthermore, to be accepted, the model has to be experienced as effectively dealing with real problems in the everyday practice of the actors in the organisations, from the bottom to the top.
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| 28. |
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| 29. |
- Flink, Maria, et al.
(författare)
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Planning for the Discharge, not for Patient Self-Management at Home - An Observational and Interview Study of Hospital Discharge
- 2017
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and objective: Despite recent interest in care transitions, little is known about how patients are prepared for the self-management tasks following the hospitalization. The objective of the study was to explore how discharge information is prepared and provided to patients in the transition from hospital to home. Method: The discharge process at three hospitals in Sweden was observed over 12 days spread over ten weeks. In total, 30 discharge encounters were observed followed by interviews with patients and professionals. Data were analysed using qualitative content analysis. Results: Much time, effort and resources were used to prepare the discharge; home-going teams and registered nurses planned the practical and social aspects of the discharge and the physicians compiled a plain-language discharge letter. Less focus was given on the actual discharge information to the patients. The discharge encounters lasted for a median of 4: 46 minutes and the information had a retrospective focus with information on the hospitalization period, though omitting self-management tasks and lifestyle advice. Conclusion: The discharge letter constitutes the basis for all patient information at discharge. The focus of the discharge encounter needs to be extended beyond mere information to include patient understanding, motivation and skills for self-management at home.
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| 30. |
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| 31. |
- Frykholm, Oscar, et al.
(författare)
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User-centered design of integrated eHealth to improve patients' activation in transitional care
- 2016
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 16:6, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The burden of chronic diseases is expected to escalate worldwide. Despite extensive use of emergency rooms and specialized care of persons with multiple or chronic diseases, the majority of the time care is managed in the patient’s home. For patients, living with chronic illnesses can be highly demanding, requiring them to manage their symptoms, disabilities and complex medical regimens at home. Effectively functioning in the role of self-manager requires a high level of knowledge, skill, and confidence. In order to handle these challenges, new models for care are required.eHealth solutions, successfully implemented in everyday clinical practice have shown significant effects on symptom management and self-efficacy, improving quality of care. Despite the wide proliferation and everyday use of consumer technology as well as eHealth solutions, the contribution of eHealth solutions in enhancing patients’ activation in self-management of their care is an underdeveloped field. Therefore, we undertake a long-term project of developing an eHealth solution where patients and care-givers are active stakeholders, and in parallel, paving the way for clinical ownership of the eHealth solution, in order to evaluate it in a randomized controlled study. The aim of this abstract is to describe the user-centered design in the development of an eHealth service.Theory and Method: We report process data from an ongoing study; aiming to improve transitional care by focusing on patient activation and participation during the critical post-hospitalization phase. We draw upon principals of the evidence-based Care Transition Intervention, which will be integrated into an eHealth solution, as a ‘digital coach’ to support patients’ self- management. We have identified four pillars that will form the foundation of the eHealth solution: care plan, medication self-management, symptom management, and contact information to relevant care-givers.In the first phase of the project, we have utilized a user-centered design process by engaging patients and care-givers in interviews, workshops and design activities. Results from these activities are documented in user-centered material such as patient journeys, effect maps, and prototypes of the eHealth solution. This material has been directly fed into the development of the technical solution, making us confident that the proposed solution will solve concrete user needs. At the same time, we make long-term collaborations with the care-givers and departments, from where the eHealth solution will be distributed to patients in the study.Progress report: A number of observational and design activities have been conducted with both patients and care-givers, at two different hospitals. User context has been documented in patient journeys, which describe a typical patient’s journey from first symptom through medical evaluation and treatment, up to living with the disease or complications of the treatment. The patient journey describes, in different stages, how the patient´s feels, their contact with health care, what information they receives and requires, and what examinations and treatments they undergoes. Visualizing health care from the patient’s perspective in this manner helps identifying gaps in e.g. information needs and to position the eHealth solution in situations where it can solve concrete needs. Furthermore, user needs have been captured in effect maps, which connect hands-on needs or functionality with high-level goals (e.g. ultimately enhanced patient activation and reduced re-hospitalization). As of now, in the second phase of the project, development of technical solution has commenced, and we are planning for pilot testing in the next couple of months.Discussion and conclusions: eHealth solutions play an important part in improving activation and awareness. However, it is not simply solved by the sheer introduction of eHealth solutions we have learned that it requires:- Successful implementation in the health care processes, as personnel should feel an ownership of the eHealth solution in order to perceive it as an effective tool in their communication with patients and collaboration with other care givers.- Presentation of relevant feedback to patients, in order for them to learn about their own disease and symptoms, and to be actively engaged in self-management at home Using motivational gamification in eHealth solutions will help to capture patients’ interest to take active role in their own care, and to motivate patients to learn and maintain self-management knowledge and skills.- Fitting it into the existing eco system of technical solutions for health care as well as patient- and lifestyle-centered applications.
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| 32. |
- Furenbäck, Ingela, 1963-
(författare)
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Improving the quality of care through communication arena
- 2013
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Ingår i: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 13:WCIC Conf Suppl
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Collaboration has become an increasingly more common strategy when developing care sectors while, coincidentally, experience and research show that collaboration development may be problematic in itself. This study aims to achieve better understanding of collaboration processes.Method: A local project that aimed at improving the quality of healthcare and social care by developing the co-operation between organizations took place in Sweden, and by using participatory action research, PAR, this process was followed between 2004 and 2008. Material was gathered through participant observation from the perspective of patients, relatives, staff, managers and politicians. A descriptive narrative was compiled and a hermeneutic interpretation was performed.Results: Initially, the development of collaboration was impeded due to lack of communication between the participants from various levels within the organizations. With the support of PAR, communication arenas were arranged to handle social interaction as well as different perspectives and conflicts, which led to improved collaboration within the organizations as well as between the care organizations.Conclusion: Development of collaboration between organizations reflects how collaboration within one organization works. Collaboration is a social and interpersonal phenomenon, and readily available communication arenas are crucial for its development.
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| 33. |
- Furenbäck, Ingela, 1963-
(författare)
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Improving the quality of care through communication arena
- 2013
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Ingår i: Internation Journal of Integrated Care. - : Ubiquity Press. ; 13:WCIC Conf Suppl
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Collaboration has become an increasingly more common strategy when developing care sectors while, coincidentally, experience and research show that collaboration development may be problematic in itself. This study aims to achieve better understanding of collaboration processes.Method: A local project that aimed at improving the quality of healthcare and social care by developing the co-operation between organizations took place in Sweden, and by using participatory action research, PAR, this process was followed between 2004 and 2008. Material was gathered through participant observation from the perspective of patients, relatives, staff, managers and politicians. A descriptive narrative was compiled and a hermeneutic interpretation was performed.Results: Initially, the development of collaboration was impeded due to lack of communication between the participants from various levels within the organizations. With the support of PAR, communication arenas were arranged to handle social interaction as well as different perspectives and conflicts, which led to improved collaboration within the organizations as well as between the care organizations.Conclusion: Development of collaboration between organizations reflects how collaboration within one organization works. Collaboration is a social and interpersonal phenomenon, and readily available communication arenas are crucial for its development.
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| 34. |
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| 35. |
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| 36. |
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| 37. |
- Hallberg, Anna, 1989-, et al.
(författare)
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Balancing Pragmatism and Sustainability : A Case Study of an Interorganisational Network to Improve Integrated Care for the Elderly
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Networks constitute a promising strategy for interorganisational collaboration, but may fail due to network tensions. By investigating the activities and internal dynamics of a voluntary meso-level network operating in the intersection of health and social care, this study aims to enhance the understanding of the relationship between pragmatism and sustainability and the role network governance plays in this respect.Methods: In this descriptive case study, 2–3 researchers observed 3 three-hour long network meetings during the course of a year, and four complementary interviews were performed. Data were analysed based on the literature on network functioning and effectiveness.Results: Pragmatism (a focus on ‘getting things done’) was more emphasised than sustainability although the network meetings also contained elements of relationship- and trust-building. The network leadership (a Network Administrative Organisation, NAO) created structure and concretized the participants’ ideas while remaining flexible and perceptive, and also carried out tasks which would otherwise not have been performed.Discussion: The emphasis on pragmatism did not seem to influence sustainability negatively which has been pointed out as a potential risk in previous literature. Rather, the focus on pragmatism reinforced sustainability in a way that is similar to what has been described in prior research as a “trust-building loop” and discussed further in terms of a “perception of progress” mechanism. However, it was unclear what future the voluntary network would have without the NAO.Conclusion: Network governance is instrumental to success, and should be carefully considered when initiating interorganisational network initiatives for integrated care.
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| 38. |
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| 39. |
- Hedman, Nils-Olof, et al.
(författare)
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Clustering and inertia : Structural integration of home care in Swedish elderly care
- 2007
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 7:july-september, s. e32-
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To study the design and distribution of different organizational solutions regarding the responsibility for and provision of home care for elderly in Swedish municipalities. Method: Directors of the social welfare services in all Swedish municipalities received a questionnaire about old-age care organization, especially home care services and related activities. Rate of response was 73% (211/289). Results: Three different organizational models of home care were identified. The models represented different degrees of integration of home care, i.e. health and social aspects of home care were to varying degrees integrated in the same organization. The county councils (i.e. large sub-national political-administrative units) tended to contain clusters of municipalities (smaller sub-national units) with the same organizational characteristics. Thus, municipalities' home care organization followed a county council pattern. In spite of a general tendency for Swedish municipalities to reorganize their activities, only 1% of them had changed their home care services organization in relation to the county council since the reform. Conclusion: The decentralist intention of the reform�to give actors at the sub-national levels freedom to integrate home care according to varying local circumstances�has resulted in a sub-national inter-organizational network structure at the county council, rather than municipal, level, which is highly inert and difficult to change.
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| 40. |
- Hjelm, Markus, et al.
(författare)
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Family members of older persons with multi-morbidity and their experiences of case managers in Sweden : an interpretive phenomenological approach
- 2015
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Ingår i: International Journal of Integrated Care. - : Igitur Publishing. - 1568-4156. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. The aim of the study was to deepen the understandning of the importance of case managers to family members of older persons (75+) with multi-morbidity. The study design was based on an interpretive phenomenological approach. Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. The findings revealed one overarching theme: "Helps to fulfil my unmet needs", based on three sub-themes: (1) "Helps me feel secure - Experiencing a trusting relationship", (2) "Confirms and strengthens me - Challenging my sense of being alone" and (3) "Being my personal guide- Increasing my competence". The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members.
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| 41. |
- Holmesland, Anne-Lise, et al.
(författare)
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Open Dialogues in social networks : professional identity and transdisciplinary collaboration
- 2010
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Ingår i: International Journal of Integrated Care. - 1568-4156 .- 1568-4156. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this article is to explore the challenges connected to the transformation and emergence of professional identity in transdisciplinary multi-agency network meetings and the use of Open Dialogue. Introduction: The empirical findings have been taken from a clinical project in southern Norway concerning multi-agency network meetings with persons between 14 and 25 years of age. The project explores how these meetings are perceived by professionals working in various sectors. Methodology: Data was collected through three interviews conducted with two focus groups, the first comprising health care professionals and the second professionals from the social and educational sectors. Content analysis was used to create categories through condensation and interpretation. The two main categories that emerged were 'professional role' and 'teamwork'. These were analysed and compared according to the two first meeting in the two focus groups. Results and discussion: The results indicate different levels of motivation and understanding regarding role transformation processes. The realization of transdisciplinary collaboration is dependent upon the professionals' mutual reliance. The professionals' participation is affected by stereotypes and differences in their sense of belonging to a certain network, and thus their identity transformation seems to be strongly affected. To encourage the use of integrated solutions in mental health care, the professionals' preference for teamwork, the importance of familiarity with each other and knowledge of cultural barriers should be addressed.
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| 42. |
- Hultberg, Eva-Lisa, 1952, et al.
(författare)
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Evaluation of the effect of co-financing on collaboration between health care, social services and social insurance in Sweden.
- 2002
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Ingår i: International journal of integrated care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we present an ongoing research project aimed to determine the impact of co-financing on collaboration around patients with musculoskeletal disorders. A trial legislation that allows the social insurance, social services and health care services to unite in co-financing under joint political steering has been tested in different areas in Sweden. In a series of studies, we compare collaboration processes and health outcome for patients with musculoskeletal disorders between health centres with co-financing projects and control health centres without co-financing projects. In this paper the studies are described and some preliminary results are discussed.
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| 43. |
- Hägglund, Maria, et al.
(författare)
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Bridging the gap : a virtual health record for integrated home care
- 2007
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 7:June, s. e26-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The coexistence of different information systems that are unable to communicate is a persistent problem in healthcare and in integrated home care in particular. THEORY AND METHODS: Physically federated integration is used for design of the underlying technical architecture to implement a mobile virtual health record for integrated home care. A user centered system development approach is followed during design and development of the system. RESULTS: A technical platform based on a service-oriented approach where database functionality and services are separated has been developed. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardized way. A physically federated integration enables point-of-care documentation, integrated presentation of information from different feeder systems, and offline access to data on handheld devices. Feeder systems deliver information in XML-files that are mapped against an ideal XML schema, published as an interface for integration with the information broker, and inserted into the mediator database. CONCLUSIONS: A seamless flow of information between both different care professionals involved in integrated home care and patients and relatives is provided through mobile information access and interaction with different feeder systems using the virtual health record.
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| 44. |
- Hägglund, Maria, Lektor, 1975-, et al.
(författare)
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Does user centred design work in homecare for elderly? : a retrospective on the OLD@HOME case
- 2011
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Ingår i: International Journal of Integrated Care. - Utrecht : Igitur. - 1568-4156 .- 1568-4156. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Mobile information and communication technology (ICT) has been suggested to improve collaboration in integrated homecare, yet, few successful implementations are available. User centred design (UCD) can improve the usefulness of ICT, however, it is often claimed to be expensive and difficult to use in healthcare. In the action research project OLD@HOME (Sweden 2002–2005) a user centred approach was adapted to the specific context of integrated homecare for elderly.Aim: To revisit OLD@HOME and explore what methodological adjustments were needed to adapt UCD to integrated homecare of elderly, and what the long-term effects of using UCD were.Results: Our collaborative design method included all stakeholders and enabled development of both new work situations and new tools. Five years after implementation, the system is still used by home help service personnel, for both homecare- and office-based work, as it provides ubiquitous access to information and communication. Technical support is rarely needed; experienced users handle occurring problems, training and introduction of new users.Conclusions: We consider the development method a key factor for the OLD@HOME system’s success as it enabled the design of a homecare system that is not only easy to use, but adapted to the context of integrated homecare for elderly
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| 45. |
- Jaarsma, Tiny, et al.
(författare)
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Practical guide on home health in heart failure patients
- 2013
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Ingår i: International Journal of Integrated Care. - : Utrecht University, Maastricht University, Groningen University. - 1568-4156 .- 1568-4156. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis, and it is also costly for society. Better integrated care is warranted in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. less thanbrgreater than less thanbrgreater thanMethod: We developed a guide on Home Health in Heart Failure patients from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. less thanbrgreater than less thanbrgreater thanResults: In integrated home care for heart failure patients, it is advised to consider the following components: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. less thanbrgreater than less thanbrgreater thanDiscussion: We summarised the state of the art of home-based care for heart failure patients in Europe, described the typical content of such care to provide a guide for health care providers.
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| 46. |
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| 47. |
- Johansson, Erika, et al.
(författare)
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Let’s Try Social Prescribing in Sweden (SPiS) : an Interventional Project Targeting Loneliness among Older Adults Using a Model for Integrated Care: A Research Protocol
- 2021
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 21:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Loneliness and social isolation among older adults (≥65) are an emerging issue of public concern, associated with increased morbidity and mortality. Today there is no systematic intervention developed, implemented or evaluated in Sweden addressing loneliness. The overall aim for this project is to develop, test and refine a person-centred Swedish model for social prescribing (SPiS), and to assess whether and how it reduces loneliness, promotes health and improves well-being among older adults.Description: The focus will be to develop, culturally adapt, evaluate and refine the SPiS model. Following the sequential structure of realist evaluation in three consecutive phases qualitative and quantitative data along with subsequent analysis methods will be collected and utilized. The project will provide knowledge of what works with the social prescribing model, for whom, in what conditions and why, in relation to loneliness, health and well-being among older adults.Discussion: SPiS has the unique position of providing initial knowledge regarding how to reduce loneliness in the Swedish context. However, evaluation is complex as this research goes beyond the unidimensional question “Is it working?”.Conclusion: Developing, implementing and evaluating such a complex program needs systematic and close evaluation.
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| 48. |
- Johansson, Staffan, 1953, et al.
(författare)
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Democratic Accountability in Strategic Coordination Bodies — An Investigation of Governance in Swedish Elder Care
- 2019
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 19:2, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- The establishment of strategic coordination bodies with members from different agencies and that are governed by various laws and regulations can be understood as an answer to the demand for improved coordinated care for citizens with complex needs, such as frail older people. However, this demand raises fundamental questions of democratic control and accountability in the modern welfare state. Although these issues are addressed in current literature on network governance, they have not been investigated empirically very much. The aim of this paper is to investigate coordination bodies as important actors in integrated care, and especially to investigate how the members of these governance networks perceive their own influence and how they are held accountable by their principals. This study is conceptually built on theories of network governance and accountability. The empirical investigation is based on a survey with 545 respondents from 73 different coordination bodies in Sweden. The analysis shows that there seems to be an imbalance between perceived influence and perceived demands from different stakeholders to account for the services. This imbalance provides an opening for a discussion of how to improve the current situation for vulnerable groups and about new perspectives on accountability and power in the modern welfare state.
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| 49. |
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| 50. |
- Kjellberg, Inger, 1959
(författare)
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Collaborative Experience Success Stories in Integrated Care of Older People: A Narrative Analysis
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 20:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Inter-organisational collaboration is crucial in the care of older people, as is the development of integrated care. Storytelling in organisations is one way of understanding how to achieve successful collaboration. This article provides insights into the ways in which storytelling in collaborative experiences contributes to a collective identity instrumental in the successful collaborations involved in integrated care for older people. Theory: Managing cultural diversity is one specific theme in the theory of collaborative advantage; this is used in combination with theories of storytelling in organisations. Method: Interviews with staff from three different municipalities applying three various strategies for integrated care were carried out. Stories of the collaborative experiences were analysed using a narrative approach. Results: The most significant finding was that a similar type of success story was evident across all three municipalities. The story was identified as an epic-comedy story where success was accomplished through the heroic characterisations of the managers, in addition to their improvisation abilities and discretionary work towards common goals. Conclusion: It is suggested that storytelling in collaborative experiences is one way of overcoming cultural frictions between different collaborating actors and may contribute to a coherent sense of a collective identity, thus facilitating further collaboration.
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