| 1. |
- Andersson, Ann-Christine, et al.
(author)
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Challenges to Improve Inter-Professional Care and Service Collaboration for People Living With Psychiatric Disabilities in Ordinary Housing.
- 2016
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In: Quality Management in Health Care. - : Lippincott Williams and Wilkins Ltd.. - 1063-8628 .- 1550-5154. ; 25:1, s. 44-52
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Journal article (peer-reviewed)abstract
- The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back-evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.
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| 2. |
- Andersson, Ann-Christine, et al.
(author)
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Five Types of Practice-Based ImprovementIdeas in Health Care Services: An EmpiricallyDefined Typology
- 2011
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In: Quality Management in Health Care. - : Lippincott Williams & Wilkins. - 1063-8628 .- 1550-5154. ; 20:2, s. 122-130
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Journal article (peer-reviewed)abstract
- The aim of this study is to empirically identify and present different kinds of practice-based improvement ideas developed in health care services. The focus is on individual placement needs, problems/issues, and the ability to organize work on the development, implementation, and institutionalization of ideas for the health care sector. This study is based on a Swedish county council improvement program. Health care departments and primary health care centers in the Kalmar County Council were invited to apply for money to accomplish improvement projects. A qualitative content analysis was done of 183 proposed applications from various health care departments and primary health care centers. The following 5 types of improvement projects were identified: organizational process, evidence and quality, competence development, process technology, and proactive patient work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. These projects point to the various problems and experiences health care professionals encounter in their day-to-day work. To generalize beyond this improvement program and to validate the typology, we applied it to all articles found when searching for quality improvement projects in the journal Quality Management in Health Care during the last 2 years and found that all of them could be fitted into at least 1 of those 5 categories. This article provides valuable insights into the current state of improvemen work in Swedish health care, and will serve as a foundation for further investigations in this quality improvement program.
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| 3. |
- Andersson, Ann-Christine, 1968-, et al.
(author)
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Identification of children as relatives with a systematic approach: a prerequisite in order to offer advice and support
- 2018
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In: Quality Management in Health Care. - : Wolters Kluwer. - 1063-8628 .- 1550-5154. ; 27:3, s. 172-177
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Journal article (peer-reviewed)abstract
- The purpose of this study was to elucidate conditions at all system levels in a specific health care service to develop practices for identification of children as relatives. An interactive research approach with the intention to create mutual learning between practice and research was used. The participating health care service cared for both clinic in- and outpatients with psychiatric disorders. Health care professionals from different system levels (micro, meso, macro) participated, representing different professions. At the first project meeting, it was obvious that there was no systematic approach to identify children as relatives. At the micro level, activities such as a pilot survey and an open house activity were carried out. At the meso level, it was discussed how to better support collaboration between units. At the management (macro) level, it was decided that all units should appoint at least one child agent, with the aim to increase collaboration throughout the whole health care service. To change focus, in this case from only parents to inclusion of children, is an important challenge faced by health care services when forced to incorporate new policies and regulations. The new regulations contribute to increased complexity in already complex organizations. This study highlights that such challenges are underestimated.
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| 4. |
- Andersson, Ann-Christine
(author)
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Managers' views and experiences of a large-scale county council improvement program : limitations and opportunities
- 2013
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In: Quality Management in Health Care. - : Lippincott Williams & Wilkins. - 1063-8628 .- 1550-5154. ; 22:2, s. 152-160
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore and evaluate managers’ views of a large-scale improvement program, including their experiences and opinions about improvement initiatives and drivers for change. The study is based on a survey used in 2 nationwide mappings of improvement initiatives and developmental trends in Swedish health care. The participants were all managers in a county council in Sweden. Data were analyzed descriptively, and statements were ranked in order of preferences. A majority of the respondents stated that they had worked with improvements since the county council improvement program started. The managers sometimes found it difficult to find data and measurements that supported the improvements, yet a majority considered that it was worth the effort and that the improvement work yielded results. The top-ranked driving forces were ideas from personnel and problems in the daily work. Staff satisfaction was ranked highest of the improvement potentials, but issues about patients’ experiences of their care and patient safety came second and third. The managers stated that no or only a few patients had been involved in their improvement initiatives. Large-scale county council improvement initiatives can illuminate quality problems and lead to increased interest in improvement initiatives in the health care sector.
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| 5. |
- Andersson-Gäre, Boel, et al.
(author)
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The health care quality journey of Jonkoping County Council, Sweden
- 2007
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In: Quality Management in Health Care. - 1063-8628 .- 1550-5154. ; 16:1, s. 2-9
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Journal article (peer-reviewed)abstract
- For a decade Jonkoping County Council in Sweden has undertaken a countywide effort to improve health and health care with measured success. This issue describes this quality improvement journey.
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| 6. |
- Aronsson, Håkan, 1961-, et al.
(author)
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Managing health care decisions and improvement through simulation modeling
- 2011
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In: Quality Management in Health Care. - : Wolters Kluwer. - 1063-8628 .- 1550-5154. ; 20:1, s. 15-29
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Journal article (peer-reviewed)abstract
- Simulation modeling is a way to test changes in a computerized environment to give ideas for improvements before implementation. This article reviews research literature on simulation modeling as support for health care decision making. The aim is to investigate the experience and potential value of such decision support and quality of articles retrieved. A literature search was conducted, and the selection criteria yielded 59 articles derived from diverse applications and methods. Most met the stated research-quality criteria. This review identified how simulation can facilitate decision making and that it may induce learning. Furthermore, simulation offers immediate feedback about proposed changes, allows analysis of scenarios, and promotes communication on building a shared system view and understanding of how a complex system works. However, only 14 of the 59 articles reported on implementation experiences, including how decision making was supported. On the basis of these articles, we proposed steps essential for the success of simulation projects, not just in the computer, but also in clinical reality. We also presented a novel concept combining simulation modeling with the established plan-do-study-act cycle for improvement. Future scientific inquiries concerning implementation, impact, and the value for health care management are needed to realize the full potential of simulation modeling.
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| 7. |
- Book, Stefan, 1966, et al.
(author)
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Perceptions of Improvement Work in Swedish Health Care: Implications for Improvement Practices.
- 2003
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In: Quality Management in Health Care. - 1063-8628 .- 1550-5154. ; 12:4, s. 217-224
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Journal article (other academic/artistic)abstract
- This study explored perceptions of improvement work in Swedish health care. The article discusses effects that these perceptions may have on improvement processes. As part of a broader study surveying managers' (n = 2313) view of improvement work in Swedish health care, this study focused on those 845 managers who regarded their improvement work as bringing about benefits. Three underlying factors that may characterize the managers' perceptions are exposed. More than 50% of the respondents perceive a complexity in the practices and techniques associated with improvement work. Furthermore, approximately 50% of the managers recognize a conflict in the meeting between the improvement work and the organization. This indicates that adaptation is a primary concern in this work. The managers' perceptions also reveal that the experience of improvement work in Swedish health care may be positive, although the perception is that it does not necessarily generate more health care per monetary unit.ABSTRACT FROM AUTHOR
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| 8. |
- Dahlin, Sara, 1980, et al.
(author)
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Process Mining for Quality Improvement: Propositions for Practice and Research
- 2019
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In: Quality Management in Health Care. - 1063-8628 .- 1550-5154. ; 28:1, s. 8-14
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Process mining offers ways to discover patient flow, check how actual processes conform to a standard, and use data to enhance or improve processes. Process mining has been used in health care for about a decade, however, with limited focus on quality improvement. Hence, the aim of the article is to present how process mining can be used to support quality improvement, thereby bridging the gap between process mining and quality improvement. METHOD: We have analyzed current literature to perform a comparison between process mining and process mapping. RESULT: To better understand how process mining can be used for quality improvement we provide 2 examples. We have noted 4 limitations that must be overcome, which have been formulated as propositions for practice. We have also formulated 3 propositions for future research. CONCLUSION: In summary, although process mapping is still valuable in quality improvement, we suggest increased focus on process mining. Process mining adds to quality improvement by providing a better understanding of processes in terms of uncovering (un)wanted variations as to obtain better system results.
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| 9. |
- Ebbevi, David, et al.
(author)
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Value-based health care for chronic care : aligning outcomes measurement with the patient perspective
- 2016
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In: Quality Management in Health Care. - : Lippincott, Williams & Wilkins. - 1063-8628 .- 1063-8628 .- 1550-5154. ; 25:4, s. 203-212
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Journal article (peer-reviewed)abstract
- Background: Value-based health care is increasingly used for developing health care services by relating patient outcomes to costs. A hierarchical value scorecard for creating outcome measurements has been suggested: The 3-Tier model. The objective of this study was to test the model against the patient's view of value in a chronic care setting. Methods: Semistructured interviews with 22 persons with rheumatoid arthritis were conducted, transcribed, and analyzed using qualitative content analysis. Themes were extracted, and the model was critically applied and revised. Results: The study validates existing dimensions in the model but suggests adding information, social health, predictability, and continuity to make it more useful and representative of patients' preferences. Conclusion: Although the model aims to focus on outcomes relevant to patients, it lacks dimensions important to individuals with rheumatoid arthritis. The data illustrate difficulties in finding patients' preferred outcomes and imply tactics for arriving at meaningful measurements.
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| 10. |
- Edvinsson, Joakim, et al.
(author)
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Senior alert: A quality registry to support a standardized, structured, and systematic preventive care process for older adults
- 2015
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In: Quality Management in Health Care. - 1063-8628 .- 1550-5154. ; 24:2, s. 96-101
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Journal article (peer-reviewed)abstract
- The average life expectancy and the proportion of the elderly in the Western countries are increasing. The care processes used for the elderly are known to differ between the care providers in Sweden. Accordingly, the need to develop a system to support the processes in order to attain a standardized, structured, and systematic approach to improve preventive care processes for the elderly has been called for. The County Council of Jönköping developed a national Web-based quality registry, Senior Alert, with a focus on the following areas: falls, pressure ulcers, malnutrition, and oral health. The patients are evaluated using validated risk assessment instruments, and the care is planned, executed, evaluated. The registry supports the users to work with preventive care systematically and in a standardized way and provides feedback to the care providers on their preventive care processes. The registry helps the caregivers fulfill the preventive care according to the best available clinical knowledge and practice. The registry also provides the government and health care politicians with data for setting aims for elderly care. The registry is used in 90% of the municipalities and county councils throughout the country. The total number of risk assessments completed from 2009 to 2014 exceeded 1 000 000.
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