| 1. |
- Alharbi, Tariq, 1979, et al.
(author)
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Experiences of person-centred care – patients’ perceptions: qualitative study
- 2014
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In: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 13:28
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Journal article (peer-reviewed)abstract
- Background Patient care models have been implemented and documented worldwide. Many studies have focused on features that hinder and facilitate the shift to such models, including the implementation process, staff involvement, resistance to new models and cultural dimensions. However, few studies have identified the potential effects of such new care models from a patient perspective. The aim of the present study was to investigate whether patients did in fact perceive the intentions of partnership in the new care model 1 year after its implementation. Methods Sixteen participants were interviewed, selected from two wards in a medical department where a new care model had been implemented 1 year earlier. A directed deductive content analysis was selected. The aim of the directed approach to content analysis was to investigate to what extent the new care model had been implemented, using patients’ perspectives to describe the level of implementation. A coding framework was developed based on a theoretical paper that described the key features of the new care model. Results The implementation of person-centred care had clearly occurred to a large degree, even if some patients appeared not to have been exposed to the model at all. Aspects of the newly implemented care model were obvious; however, it was also clear that implementation was not complete. The analysis showed that patients felt listened to and that their own perception of the situation had been noted. Patients spontaneously expressed that they felt that the staff saw them as persons and did not solely focus on their disease. It was also stated that not every ailment or aspect of a patient’s illness needed to be addressed or resolved for open listening to be perceived as a positive experience. Conclusions The findings indicate that even though some patients were not interested in participating and playing an active role in their own care, this might relate to a lack of understanding on how to invite them to do so and to increase their confidence. To change healthcare from a paternalistic system to care where patients are seen as partners may require pedagogical skills.
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| 2. |
- Alharbi, Tariq, 1979, et al.
(author)
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Organizational culture and the implementation of person centered care: Results from a change process in Swedish hospital care
- 2012
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In: Health Policy. - : Elsevier BV. - 0168-8510. ; 108:2-3, s. 294-301
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Journal article (peer-reviewed)abstract
- Abstract Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.
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| 3. |
- Alharbi, Tariq, 1979, et al.
(author)
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The impact of organizational culture on the outcome of hospital care: After the implementation of person-centred care
- 2014
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:1, s. 104-110
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Journal article (peer-reviewed)abstract
- AIMS: To measure the effect of organizational culture on health outcomes of patients 3 months after discharge. Methods: a quantitative study using Organizational Values Questionnaire (OVQ) and a health-related quality of life instrument (EQ-5D). A total of 117 nurses, 69% response rate, and 220 patients answered the OVQ and EQ-5D, respectively. Results: The regression analysis showed that; 16% (R2 = 0.02) of a decreased health status, 22% (R2 = 0.05) of pain/discomfort and 13% (R2 = 0.02) of mobility problems could be attributed to the combination of open system (OS) and Human Relations (HR) cultural dimensions, i.e., an organizational culture being dominated by flexibility. Conclusions: The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.
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| 4. |
- Carlström, Eric, 1957, et al.
(author)
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The association between subcultures and resistance to change – in a Swedish hospital clinic
- 2014
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In: Journal of Health Organisation & Management. - 1477-7266. ; 28:4, s. 458-476
-
Journal article (peer-reviewed)abstract
- Summary: Purpose: The purpose of this paper was to explore the different subcultures and the employees’ preparedness for change at an orthopaedic clinic in a university hospital in Sweden. The idea was to describe how different working groups might react to the change, in order to discover the possible impact of the model prior to implementation. This approach was based on the fact that costly implementation processes have had disappointing results and limited impacts on some organisations. Design: Surveys were sent out to 179 nurses and physicians. The survey included the two instruments Organisational Values Questionnaire (OVQ) and Resistance to Change Scale (RTC). Findings: The results suggest a dominance of a human relations culture i.e. flexibility, cohesion and trust, in the orthopaedic clinic. These characteristics seemed to decrease resistance to change. Opposite to this, planning, routines and goal setting appeared to increase change-resistant behaviour. Practical implications: By predicting potential obstacles in a certain context prior to a change process, resources can be used in a more optimal way. An instrument that pinpoints the culture of a particular healthcare setting may be a useful tool in order to anticipate the possible outcome of change. Originality/value: The rational goal/internal processes dimension exerted a stronger association with resistance to change than in earlier studies. Deeply rooted standards and routinised care models, governed by work schedules, could be an obstacle to introducing a care model based on the individual needs of the patient. There was, however, a surprisingly low resistance to change. The results are contrary to the accepted understanding of public organisations known to be slow to change. Keywords: Change, Organisational culture, Healthcare, Working groups, Person-centred care, Sweden. Paper type: Research paper
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| 5. |
- Carlström, Eric, 1957, et al.
(author)
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The unannounced patient in the corridor - trust, friction and person centered care.
- 2017
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In: International Journal of Health Planning and Management. - : Wiley. - 0749-6753 .- 1099-1751. ; 32:1
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Journal article (peer-reviewed)abstract
- In this study, a Swedish cancer clinic was studied where three to four unscheduled patients sought support from the hospital on a daily basis for pain and nutrition problems. The clinic was neither staffed nor had a budget to handle such return visits. In order to offer the patients a better service and decrease the workload of the staff in addition to their everyday activities, a multidisciplinary team was established to address the unscheduled return visits. The team was supposed to involve the patient, build trust, decrease the friction, and contribute to a successful rehabilitation process. Data were collected from the patients and the staff. Patients who encountered the team (intervention) and patients who encountered the regular ad hoc type of organization (control) answered a questionnaire measuring trust and friction. Nurses in the control group spent 35% of their full‐time employment, and the intervention group staffed with nurses spent 30% of their full‐time employment in addressing the needs of these return patients. The patients perceived that trust between them and the staff was high. In summary, it was measured as being 4.48 [standard deviation (SD) = 0.82] in the intervention group and 4.41 (SD = 0.79) in the control group using the 5‐point Likert scale. The data indicate that using a multidisciplinary team is a promising way to handle the problems of unannounced visits from patients. Having a team made it cost effective for the clinic and provided a better service than the traditional ad hoc organization.
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| 6. |
- Högstedt, Åsa, et al.
(author)
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Characteristics and motivational factors for joining a lay responder system dispatch to out-of-hospital cardiac arrests
- 2022
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In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 30:1
-
Journal article (peer-reviewed)abstract
- Background: There has been in increase in the use of systems for organizing lay responders for suspected out-of-hospital cardiac arrests (OHCAs) dispatch using smartphone-based technology. The purpose is to increase survival rates; however, such systems are dependent on people's commitment to becoming a lay responder. Knowledge about the characteristics of such volunteers and their motivational factors is lacking. Therefore, we explored characteristics and quantified the underlying motivational factors for joining a smartphone-based cardiopulmonary resuscitation (CPR) lay responder system. Methods: In this descriptive cross-sectional study, 800 consecutively recruited lay responders in a smartphone-based mobile positioning first-responder system (SMS-lifesavers) were surveyed. Data on characteristics and motivational factors were collected, the latter through a modified version of the validated survey "Volunteer Motivation Inventory" (VMI). The statements in the VMI, ranked on a Likert scale (1-5), corresponded to(a) intrinsic (an inner belief of doing good for others) or (b) extrinsic (earning some kind of reward from the act) motivational factors. Results: A total of 461 participants were included in the final analysis. Among respondents, 59% were women, 48% between 25 and 39 years of age, 37% worked within health care, and 66% had undergone post-secondary school. The most common way (44%) to learn about the lay responder system was from a CPR instructor. A majority (77%) had undergone CPR training at their workplace. In terms of motivation, where higher scores reflect greater importance to the participant, intrinsic factors scored highest, represented by the category values (mean 3.97) followed by extrinsic categories reciprocity (mean 3.88) and self-esteem (mean 3.22). Conclusion: This study indicates that motivation to join a first responder system mainly depends on intrinsic factors, i.e. an inner belief of doing good, but there are also extrinsic factors, such as earning some kind of reward from the act, to consider. Focusing information campaigns on intrinsic factors may be the most important factor for successful recruitment. When implementing a smartphone-based lay responder system, CPR instructors, as a main information source to potential lay responders, as well as the workplace, are crucial for successful recruitment.
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| 7. |
- Koinberg, Ingalill, 1955, et al.
(author)
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Impact of a person-centered intervention for patients with head and neck cancer: A qualitative exploration
- 2018
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In: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 17:1
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Journal article (peer-reviewed)abstract
- Background: People affected by head and neck cancer (HNC) experience a variety of multifaceted health-related problems during the treatment process, based on both the disease and side effects, several years after the treatment is complete. This study investigated a person-centred intervention using transition theory as a framework. Aim: Thus, the aim of the present study was to explore patients' experience of the transition and person centred care from diagnosis to the end of the treatment period. Methods: Interviews were conducted with 12 persons included in the person-centred intervention group. The patients were recruited from a randomised controlled study. We used a directed deductive content analysis as an analysis method. Results: There was a distinct transition between being a healthy person to being diagnosed with a serious disease. The majority of the participants felt that the diagnosis had put their lives in the balance; they felt both healthy and sick at the same time, and all participants described that their symptoms and side effects were the worst possible and totally unexpected. Of great importance was the health-care plan, comprising self-management goals which were formed in partnership between the patient and the nurse. The participants experienced that their interaction and engagement with lay persons and healthcare professionals supported a gradual acceptance of the situation and a sense of relief with a kind of awareness of the disease. Conclusion: The intervention played a significant role in promoting a healthy transition. Person-centredness and transition theory can help healthcare professionals to be more confident and resourceful in supporting people affected by HNC. © 2018 The Author(s).
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| 8. |
- Abraham, Louisa J., et al.
(author)
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Morale, stress and coping strategies of staff working in the emergency department: A comparison of two different-sized departments
- 2018
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In: EMA - Emergency Medicine Australasia. - : Wiley. - 1742-6731 .- 1742-6723. ; 30:3, s. 375-381
-
Journal article (peer-reviewed)abstract
- Objective : Clinical staff in EDs are subject to a range of stressors. The objective of this study was to describe and compare clinical staff perceptions of their ED's working environment across two different Australian EDs. Methods : This was a cross-sectional, descriptive, research design that included distribution of three survey tools to clinical staff in two Australian EDs in 2016. Descriptive statistics were reported to characterise workplace stressors, coping styles and the ED environment. These data were compared by hospital and the employee's clinical role (nurse or physician). Results : In total, 146 ED nurses and doctors completed the survey (response rate: 67%). Despite geographical variation, the staff at the two locations had similar demographic profiles in terms of age, sex and years of experience. Staff reported moderate levels of workload and self-realisation but low levels of conflict or nervousness in the workplace. Nurses and physicians reported similar perceptions of the work environment, although nurses reported slightly higher median levels of workload. Staff rated the death or sexual abuse of a child as most stressful, followed by workplace violence and heavy workload. Staff used a large range of coping strategies, and these were similar across both sites. Conclusion : These findings are the first multi-site and multidisciplinary examinations of Australian ED staff perceptions, improving our understanding of staff stressors and coping strategies and highlighting similarities across different EDs. These data support the development and implementation of strategies to improve ED working environments to help ensure professional longevity of ED staff.
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| 9. |
- Alverbratt, Catrin, et al.
(author)
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The process of implementing a new working method - a project towards change in a Swedish psychiatric clinic
- 2014
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In: Journal of Hospital Administration. - : Sciedu Press. - 1927-6990 .- 1927-7008. ; 3:6, s. 174-189
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Journal article (peer-reviewed)abstract
- The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.
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| 10. |
- Andersson, Annika, 1981-, et al.
(author)
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Managing boundaries at the accident scene : a qualitative study of collaboration exercises
- 2014
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In: International Journal of Emergency Services. - : Emerald Group Publishing Ltd. United Kingdom. - 2047-0894 .- 2047-0908. ; 3:1, s. 77-94
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Journal article (peer-reviewed)abstract
- Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.Design/methodology/approach Interviews with 23 participants from four exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis.Findings Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision-making.Originality/value The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.
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| 11. |
- Andersson, Annika, 1981-, et al.
(author)
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Managing boundaries at the accident scene : a qualitative study of collaboration exercises
- 2014
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In: International Journal of Emergency Services. - 2047-0894 .- 2047-0908. ; 3:1, s. 77-94
-
Journal article (peer-reviewed)abstract
- Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.Design/methodology/approach Interviews with 23 participants from four exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis.Findings Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision-making.Originality/value The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.
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| 12. |
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| 13. |
- Bergman, Lina, 1985, et al.
(author)
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Improving quality and safety during intrahospital transport of critically ill patients: A critical incident study.
- 2020
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In: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses. - : Elsevier BV. - 1036-7314. ; 33:1, s. 12-19
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Journal article (peer-reviewed)abstract
- Intrahospital transport is a high-risk procedure for critically ill patients, yet there is little known about how the transport team manages critical incidents that occur.The aim of this study was to explore critical care nurses' and physicians' experiences and practices associated with critical incidents during the transfer process in critically ill patients.As a part of an ethnographic study, semistructured interviews were performed using the critical incident technique. Data were collected in two intensive care units at one university hospital in a Swedish metropolitan city. Critical care nurses (n=15) and physicians (n=5) were interviewed, together describing a total of 46 critical incidents. Data were analysed using qualitative content and thematic analysis approaches.Content analysis of nurses' and physicians' practices resulted in a description of requirements for safe transports, including organisational prerequisites, professional skills and attributes, as well as actions and behaviours of safely performing transfers. Exploring the experiences of nurses and physicians in transporting critically ill patients yielded three main themes. The first theme, a hazardous process, revealed how caring for critically ill patients during intrahospital transfers was perceived as an unsafe, demanding task that presents several threats to the patient's safety. However, despite worries and concerns, participants trusted their own abilities to handle unexpected events, resulting in the second theme, performing when it matters. The third theme, towards safe practice, captured suggestions for improvement and attitudes towards existing safety hazards.To prevent and manage critical incidents during intrahospital transport, findings of this study suggest that nontechnical skillssuch as situational awareness and teamworkare essential. In addition, the team must possess the requisite technical skills and knowledge to undertake transports. Finally, organisations are required to provide a supportive and sustainable transport environment that includes fewer transport-related hazards.
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| 14. |
- Bergman, Lina, 1985, et al.
(author)
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In safe hands: Patients' experiences of intrahospital transport during intensive care
- 2020
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In: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 59:August
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Journal article (peer-reviewed)abstract
- Objectives: Intrahospital transports are associated with complications and adverse events in intensive care patients. Yet, little is known about how patients' percive these tranfers. Thus, this study aimed to explore patients' experiences of the intrahospital transport process. Research Design: An exploratory qualitative study compromising interviews with twelve patients. Data were analysed using thematic analysis. Setting: Two intensive care units in a university hospital setting. Main Outcome: An understanding of patients' experiences of the intrahospital transport process. Findings: The main finding was patients' description of "being in safe hands" during the transport. Patients' experience of transports as feasible and safe was reflected in the first main theme, "feeling prepared and safeguarded". The second theme, "being on the move", described patients' perceptions of the transport; although they were aware of movement, the transport was viewed as a minor event during their stay. The third theme, "entrusting myself to others", revealed how patients handed over control and decision making to the staff, confident that they would look after their best interest. Conclusions: Patients perceived intrahospital transports as an acceptable and safe process. Findings suggest that patients' experience could be improved by being provided with accurate and timely information and preparedness for transport-related events. (C) 2020 Elsevier Ltd. All rights reserved.
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| 15. |
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| 16. |
- Bergman, Lina, 1985, et al.
(author)
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Safety Hazards During Intrahospital Transport: A Prospective Observational Study.
- 2017
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In: Critical care medicine. - 1530-0293. ; 45:10
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Journal article (peer-reviewed)abstract
- To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients.A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months.The study was undertaken at two ICUs in one university hospital.Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians.None.Content analysis was performed using deductive and inductive approaches. We detected a total of 365 safety hazards (median, 7; interquartile range, 4-10) during 51 intrahospital transports of critically ill patients, 80% of whom were mechanically ventilated. The majority of detected safety hazards were assessed as increasing the risk of harm, compromising patient safety (n = 204). Using the System Engineering Initiative for Patient Safety, we identified safety hazards related to the work system, as follows: team (n = 61), tasks (n = 83), tools and technologies (n = 124), environment (n = 48), and organization (n = 49). Inductive analysis provided an in-depth description of those safety hazards, contributing factors, and process-related outcomes.Findings suggest that intrahospital transport is a hazardous process for critically ill patients. We have identified several factors that may contribute to transport-related adverse events, which will provide the opportunity for the redesign of systems to enhance patient safety.
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| 17. |
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| 18. |
- Berlin, Johan, 1975, et al.
(author)
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Backsourcing in the private and public sectors — A systematic review
- 2023
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In: Financial Accountability and Management. - 0267-4424 .- 1468-0408. ; 39:3
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Journal article (peer-reviewed)abstract
- This article provides a systematic review of the literature on backsourcing. The aim is to synthesize existing literature in order to compare and analyze similarities and differences in backsourcing in the private and public sectors. The study asks questions about: which methods and theories have been used, why backsourcing has been implemented, and what reasons have been described for backsourcing. The study is based on an analysis of 500 articles about backsourcing and 33 articles in the final data set. The results show that backsourcing is primarily caused by: increased costs, lack of quality, and contract problems in the private sector, along with loss of control, cost saving, and changed strategy in the public sector. The study's synthesis highlights three explanations for how backsourcing is managed and interpreted in both the sectors. The article contributes specifically to summarizing current research on backsourcing, synthesizing how backsourcing has been studied, illustrating gaps in the research, as well as explaining relevant differences between private and public backsourcing.
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| 19. |
- Berlin, Johan, 1975, et al.
(author)
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Balans eller nonchalans? - En studie av kommuner som beviljats extra finansiellt stöd av staten.
- 2003
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Reports (other academic/artistic)abstract
- De ekonomiska problemen i kommunsektorn kring sekelskiftet ledde fram till ett system för extra stöd till kommuner i särskilt bekymmersamma situationer. Stödet söks hos den statliga kommundelegationen (”kommunakuten”) som för att bevilja detta stöd kräver motprestationer i form av ekonomisk sanering. I tidigare undersökningar har ekonomicheferna i de kommuner som beviljats bidrag tillfrågats om orsakerna till att kommunen hamnat i denna situation. I rapporten testas ett statistiskt material på deras föreslagna förklaringar. I den slutliga analysen visas att orsaken bäst förklaras av variationer i nettokostnader. Bakom kostnadsvariationerna ligger demografiska förhållanden som befolkningsminskning, invånarantal och andel äldre. Flera av ekonomichefernas föreslagna förklaringar till den svåra ekonomiska situationen har inte gått att belägga i den statistiska analysen. I rapporten förs även en diskussion om att det finns en risk för att kommuner visar upp de egenskaper som omgivningen förväntar sig av dem. På så sätt bildas en institution för vad som präglar en ”fattig kommun”. Detta förhållningssätt kan gälla i synnerhet när det är politiskt svårt att driva igenom kostnadsminskningar. Avslutningsvis problematiseras kommunernas situation utifrån olika fokus på rättvisa samt hur balansen mellan kostnader och intäkter tar sig uttryck i fyra fiktiva situationer.
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| 20. |
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| 21. |
- Berlin, Johan, 1975, et al.
(author)
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Blåljusorganisationer på olycksplatsen. - Om samverkansminimering
- 2009
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In: Petra Adolfsson & Rolf Solli (Red). Offentlig sektor och komplexitet. Om hantering av mål, strategier och professioner.. - Lund : Studentlitteratur. - 9789144057804 ; , s. 59-79
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Book chapter (other academic/artistic)
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| 22. |
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| 23. |
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| 24. |
- Berlin, Johan, 1975-, et al.
(author)
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Collaboration Exercises : the lack of collaborative benefits
- 2014
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In: International Journal of Disaster Risk Science. - : Springer Science and Business Media LLC. - 2095-0055 .- 2192-6395. ; 5:3, s. 192-205
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Journal article (peer-reviewed)abstract
- The purpose of this paper is to study what professional emergency personnel learn during collaboration exercises and the benefits of what they have learned. Observations (n=19) and semistructured interviews (n=32) were carried out in conjunction with major exercises held in Sweden (2007–2012). The results show that exercises tend to be based on its own logic, which differs from actual events. Exercise participants believe that they mainly learn single-track, parallel and path-dependent behavior. The exercises do not facilitate the use of cross-boundary activities. This means that learning as well as benefits of the exercises for actual events is limited. The exercises would be more appropriate if those participating had the opportunity to identify weaknesses, try alternative ways as well as had the opportunity to have comprehensive organizational analyses at the conclusion of the exercises. Based on the results of the study, alternative models for the exercises are suggested that contain elements, which develop collaboration and contribute to learning.
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| 25. |
- Berlin, Johan, 1975-, et al.
(author)
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Cultural camouflage : a critical study of how artefacts are camouflaged and mental health policy subverted
- 2015
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In: International Journal of Health Planning and Management. - : Wiley. - 0749-6753 .- 1099-1751. ; 30:2, s. 111-126
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Journal article (peer-reviewed)abstract
- This study identifies hidden artefacts in a public organisation. In contrast to earlier studies, itfocuses on artefacts as concealing rather than conveying meaning. Negligent behaviour causedby an unpopular culture was recognised in five psychiatric wards at a Swedish universityhospital. Data comprising observations (87 h) and interviews (n = 60) were collected over aperiod of 48months (2008–2011). Four different items used in everyday work representing adeeper meaning of the organisation were identified during the observations. The items selectedwere work attire, nametags, keys and restraint beds. These were considered particularly promisingwhen it came to the aim of the study, namely, to find out how artefacts are camouflaged. Theobservations and the interviews revealed that these were controversial and contested artefacts inthe organisation. The study uses the term ‘cultural camouflage’ for behaviour that ignores andconsciously conceals symbols that have negative values. This concept contrasts with previousresearch that shows how artefacts are emphasised and how they contribute to the character ofthe activity in a transparent way. Conservative and backward-looking behaviour among staffprovided one explanation as to why artefacts were concealed. Another was the need to establishharmonious internal interactions.
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Berlin, Johan, 1975-, et al.
(author)
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From artefact to effect : the organising effects of artefacts on teams
- 2010
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In: Journal of Health Organization & Management. - : Emerald. - 1477-7266 .- 1758-7247. ; 24:4, s. 412-427
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Journal article (peer-reviewed)abstract
- Purpose – Earlier studies have identified artefacts, but have only to a lesser degree looked at theireffects. The purpose of this paper is to investigate how artefacts contribute to organisation. Design/methodology/approach – A trauma team at a university hospital has been observed andits members interviewed. Findings – The trauma team showed itself to be rich on artefacts since it had strong internal drivingforces, high legitimacy, and tried to live up to high expectations from the outside. Its members were motivated to be in the forefront of trauma care. Through renewal, the team succeeded in maintaining demarcation. It also succeeded in systemising internal work tasks and made for itself a position in relation to the outside. The team's capacity, however, came to be limited by internal conflicts and battles for prestige. Practical implications – The study shows that informal logic has a strong influence on teams.Teamwork contributed to the development of organisational structure and motivation for the personnel. Originality/value – Earlier studies advocate the important role of artefacts in order to communicate, collaborate, negotiate or coordinate activities. The conclusion is that artefacts also have an organising and developing effect on teams in a fragmented and differentiated healthcare.
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| 30. |
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| 31. |
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| 32. |
- Berlin, Johan, 1975, et al.
(author)
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Involuntary backsourcing in the public sector ‐ From conflict to collaboration
- 2022
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In: Public Administration. - : Wiley. - 0033-3298 .- 1467-9299. ; 100:3, s. 674-691
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Journal article (peer-reviewed)abstract
- The aim of this study is to contribute to the literature on how involuntary backsourcing in public organisations is performed in practice and how it affects the relationship between principal and agent. The study focuses on two questions; 1) Which stages characterise the process when public contracts are involuntary terminated? 2) How does involuntary backsourcing affect the relationship between principal and agent during the transfer period? The study's case concerns public backsourcing in Sweden, in particular, how a metropolitan municipality manages involuntary backsourcing. This study provides in‐depth insights into backsourcing and its practice, as well the degree to which the conflict dimension between the parties is affected. The study shows ‐ paradoxically ‐ that the relationship between principal and agent during the transition phase is characterised by dependence, mutual exchange of information, collaboration and less conflict. The study contributes to developing the theory of backsourcing, particularly the behaviour that is played out between principal and agent in the transition stage. The findings identify the need for public organisations which make outsourcing decisions to have contingency plans for bringing operations back in‐house.
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| 33. |
- Berlin, Johan, 1975-, et al.
(author)
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Learning and usefulness of collaboration exercises : A study of the three level collaboration (3LC) exercises between the police, ambulance and rescue services
- 2015
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In: International Journal of Mass Emergencies and Disasters. - 0280-7270. ; 33:3, s. 428-467
-
Journal article (peer-reviewed)abstract
- In this article, we studied collaboration exercises (3LC) between the rescue services, ambulance services, and police force, which were developed to enhance learning and usefulness. The exercises’ structure was based on identified deficiencies in previous collaboration exercises. The purpose was to test the exercise model in terms of learning and usefulness. Ten 3LC exercises were observed. A total of 65 semi-structured interviews were conducted (2011–2014) in connection with the exercises. The exercises contained across-boundary elements, seminars, and interactive documentation. The participants were given the opportunity to discuss, analyze, and critically reflect on their efforts. During the seminars, the individual actions were analyzed, which led to alternative strategies that were subsequently tested in a repeated exercise. Our results demonstrate that repetitive features and seminars during collaboration exercises promote learning toward an organic behavior and usefulness in the actual incident work.
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| 34. |
- Berlin, Johan M, 1975-, et al.
(author)
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Collaboration exercices; what do they contribute? : a study of learning and usefulness
- 2015
-
In: Journal of Contingencies and Crisis Management. - : Wiley. - 0966-0879 .- 1468-5973. ; 23:1, s. 11-23
-
Journal article (peer-reviewed)abstract
- This article aims to study whether exercises contribute to learning that can be useful in actual emergency work. It reports the findings of a study about professional emergency personnel’s perceptions of the impact of collaboration exercises. Surveys were distributed and collected from emergency personnel in conjunction with three collaboration exercises that took place in Sweden in spring 2012. The survey included personnel holding different positions within the police department, fire department and ambulance services. Among them were also operational personnel such as officers. A total of 94 professional emergency personnel agreed to participate by answering the survey. The response rate was 95%.The study shows that collaborative elements in exercises contribute to perceived learning (R2 = 0:53), and that learning, in turn, has a perceived beneficial effect on actual emergency work (R2 = 0:26).The perceived results of collaboration,learning and their impact on actual emergency work, however, are moderate.The exercises were characterised by long waiting times and gave few opportunities to practise different strategies. Only a few respondents felt that they learned something about the collaborating organisations’ ways of communicating and prioritising. Many also thought that the exercises were more useful for command officers than for operational personnel.Thus, the study shows that by strengthening the collaborative elements of the exercises, the perception of the participants’ actual emergency work can be developed.
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| 35. |
- Berlin, Johan, 1975-, et al.
(author)
-
Models of teamwork: ideal or not? : A critical study of theoretical team models
- 2012
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In: Team Performance Management. - : Emerald. - 1352-7592 .- 1758-6860. ; 18:5/6, s. 328-340
-
Journal article (peer-reviewed)abstract
- Purpose - There is a tendency in team research to employ concepts of stepwise models, reachingfrom the primitive to the excellent, to suggest that a higher level of evolution is better than the basic and simple. This tendency includes typologies of teams. This article aims to question the relevance of this view.Design/methodology/approach - Data were collected in three steps. In the first step, articles and books analyzing teams and teamwork from stepwise analytical models were collected. In the second step the collected data were classified into different themes. Each stepwise model was classified into one essential denomination. This classification resulted in eight themes. In the third step each theme was analyzed, which led to the fusion of some of the themes.Findings - The conclusion is that a synchronous, complementary or mature team is not necessarily optimal. Contrary to this, a differentiated, sequential or multi team approach can be optimal for some purposes. Team research needs to establish a more open, inductive and critical attitude than at present.Originality/value - The paper highlights the need to observe and use team theories in a balanced and critical way.
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| 36. |
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| 37. |
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| 38. |
- Berlin, Johan, 1975, et al.
(author)
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Organisatorisk samverkan på olycksplatsen. - Om stabilitet och förändring.
- 2007
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In: Göteborg Public Management Seminar - On risk and leadership. (GPMS) 19-20 November 2007..
-
Conference paper (peer-reviewed)abstract
- Denna artikel handlar om organisatorisk samverkan på olycksplatsen. Varje år genomförs ett antal övningstillfällen där personal från ambulans, räddningstjänst och polis övar på mellanorganisatorisk samverkan. Tidigare forskning har visat att samverkan är svårt att åstadkomma. Den forskningsfråga som ställs inom ramen för denna artikel är: varför samverkansövning?
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| 39. |
- Berlin, Johan, 1975-, et al.
(author)
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Samverkan mellan blåljusorganisationer
- 2011. - 1
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Book (other academic/artistic)abstract
- Samverkan mellan olika yrkesprofessioner på en olycksplats är komplicerat. Mycket på grund av att förväntningarna inte alltid överensstämmer med förutsättningarna. I boken problematiseras agerandet på olycksplatsen. Friktionen mellan yrkesprofessioner lyfts fram och olika beteendemönster diskuteras.I boken tar författarna samverkan från retorik till ett praktiskt redskap, något som är möjligt att konkretisera och utföra praktiskt i det dagliga arbetet. Boken utgör samtidigt en introduktion till övningstekniken 3-nivåsamverkan (3-NS).I den här boken bjuds på flera närgångna beskrivningar. Medarbetare från fältet berättar om sina erfarenheter av samverkan, hur den tillämpas, om vilka möjligheter som finns och vilka svårigheter som behöver hanteras.Boken riktar sig till alla som arbetar i eller i anslutning till blåljusorganisationer. Den kan med fördel användas som lärobok för universitets- och högskolestuderande som läser till yrken inom polis, räddningstjänst eller ambulanssjukvård. Boken passar också för vidareutbildning av redan yrkesverksamma. Den kan även med fördel läsas av forskare, tjänstemän och politiker med intresse för hur framtidens blåljusorganisationer ska ledas, organiseras och styras.
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| 40. |
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| 41. |
- Berlin, Johan, 1975-, et al.
(author)
-
Samverkansövningar : Om lärande och nytta
- 2015. - 1
-
Book (other academic/artistic)abstract
- Den här studien handlar om samverkansövningar med särskilt fokus på fullskaleövningar mellan polis, räddningstjänst och ambulans. För att lyckas i en komplex situation behöver personalens förmåga att samverka organisationsövergripande utvecklas och förfinas.Det övergripande syftet med denna studie var att studera hur samverkan övas och hur övningarna leder till lärande och nytta. I studien gjordes inledningsvis en forskningsöversikt. Utifrån den har ett antal centrala begrepp tagits fram som varit till hjälp när vi följt svenska samverkansövningar genom intervjuer och observationer. Den samlade analysen har sedan legat till grund för konstruktionen av en ny övningsmodell, 3NS, trenivåsamverkan. Den bygger på erfarenheter vi gjort i studier av traditionella övningar.De 3NS-övningar som genomfördes bestod av två praktiska moment och tre seminarier. Varje moment följdes av ett utvärderande seminarium som syftade till att deltagarna själva skulle reflektera och utveckla sitt handlingsmönster. De båda praktiska momenten var identiska. Det gav de övande tillfälle att repetera och metodiskt prova nya angreppssätt. Det första övningsmomentet genomfördes enligt de rutiner som normalt tillämpas och styr handlandet vid en skarp händelse. Det andra övningsmomentet föregicks av ett självkritiskt seminarium där deltagarna själva identifierade vad som kunde förbättras till nästa övningsomgång.Forskningsprojektet har genomförts 2011-2014. Totalt har 19 samverkansövningar studerats, varav 16 fullskaleövningar. I studien har totalt 97 intervjuer och 125 timmar observation genomförts. En enkät (CLU-instrument) har utvecklats, vilken besvarats av 272 övningsdeltagare.Studien visar att kollaborativa moment vid övningar bidrar till att deltagarna lär sig mer och har större nytta av övningar. 3NS-övningarna uppfattades förbättra lärandet med 26 procent och nyttan med 17 procent jämfört med traditionella övningar. Samverkansövningar gynnas av att de övande själva analyserar sina svagheter. Repetitiva inslag där de övande prövar alternativa strategier förbättrar beredskapen inför skarpa händelser.
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| 42. |
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| 43. |
- Berlin, Johan, 1975, et al.
(author)
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Sjuksköterskan som chef och ledare
- 2017
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In: Sandberg H. (red). Pedagogik för sjuksköterskor. - Lund : Studentlitteratur. - 9789144093956
-
Book chapter (peer-reviewed)
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| 44. |
- Berlin, Johan, 1975, et al.
(author)
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Team i hälso- och sjukvården.
- 2005
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In: Nordic Conference on Business Studies. School of Business, Århus. 18-20 Augusti 2005..
-
Conference paper (peer-reviewed)abstract
- I denna studie ställs frågan: Vad karaktäriserar team inom hälso- och sjukvård? För att besvara frågan har såväl konsultlitteratur som empirisk litteratur granskats. Detta har bidragit till att ett teams karaktär kan beskrivas på två sätt. Dels har team karaktären av förväntade egenskaper, dels har det karaktären av uppvisade egenskaper. Förväntade egenskaper återges i management litteratur som idealiserade förväntningar av vad team kan åstadkomma, uppvisade egenskaper återges i empirisk och kritisk litteratur där team och teams utveckling beskrivits. I studien sammanfattas dessa egenskaper som dikotomier fördelade på externa karaktärsdrag, karaktärsdrag hos ledning, uttryck för mål, inci-tament som driver teamarbetet och interna karaktärsdrag. De begrepp som deducerats fram prövas på tre hälso- och sjukvårdsteam. Dessa utgörs av ett tandvårdsteam, ett vårdcentralsteam och ett traumateam. Resultatet pekar på att de granskade hälso- och sjukvårdsteamen hade fler av de förväntade egenskaperna än de uppvisade. Dominerande egenskaper hos dessa team var att de var normativt motiverade och uppgiftsfokuserade. Detta tolkas som att hälso- och sjukvårdsteamens medlemmar bär ett gemensamt intresse av att behandla och vårda patienter. Denna normativa motivation bidrar till flexibla och synkrona arbetsformer. Hälso- och sjukvårdsteamens medlemmar har också individuella incitament för att arbeta i team. Det finns ett inslag av status och glamour att arbeta i dessa team. Detta incitament bidrar också till flexibla och synkrona beteenden eftersom det upprätthåller en bild av teamet gentemot en omgivande publik. Resultatet pekar på att hälso- och sjukvårdsteam inte har svårt att hävda sig, de är inte enkelriktade, de är inte utilitaristiskt motiverade, och medlemmarna betraktar det inte som en eftergift att vara medlem i teamen.
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| 45. |
- Berlin, Johan, 1975, et al.
(author)
-
The 20-minute team : a critical case study from the emergency room
- 2008
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In: Journal of Evaluation in Clinical Practice. - : Wiley. - 1356-1294 .- 1365-2753. ; 14:4, s. 569-576
-
Journal article (peer-reviewed)abstract
- Rationale: In this article, the difference between team and group is tested empirically. The research question posed is How are teams formed? Three theoretical concepts that distinguish groups from teams are presented: sequentiality, parallelism and synchronicity. The presumption is that groups cooperate sequentially and teams synchronously, while parallel cooperation is a transition between group and team. Methods: To answer the question, a longitudinal case study has been made of a trauma team at a university hospital. Data have been collected through interviews and direct observations. Altogether the work of the trauma team has been studied for a period of 5 years (2002–2006). Results: The results indicate that two factors are of central importance for the creation of a team. The first is related to its management and the other to the forms of cooperation. To allow for a team to act rapidly and to reduce friction between different members, clear leadership is required. Conclusions: The studied team developed cooperation with synchronous elements but never attained a level that corresponds to idealized conceptions of teams. This is used as a basis for challenging ideas that teams are harmonious and free from conflicts and that cooperation takes place without friction.
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| 46. |
- Berlin, Johan, 1975, et al.
(author)
-
The 90 Second Collaboration - A critical study of collaboration exercises at extensive accident sites
- 2008
-
In: Journal of Contingencies and Crisis Management. - : Wiley. - 0966-0879 .- 1468-5973. ; 16:4, s. 177-185
-
Journal article (peer-reviewed)abstract
- In this study, a critical examination of collaboration, focusing on the alternatives, is carried out. The study is based on empirical data from four inter-organizational exercises involving ambulance police and fire departments. We studied collaboration between the three organizations, from the arrival of the first units, until the mission was completed. It was found that collaboration was practiced to a relatively small degree, and that it primarily took place due to understaffing. In summary, the different organizational phenomena are sorted on a scale of stability vs. change. The result of the study shows that the organizations observed strive for stability, preferring repeated and well-known behaviour.
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| 47. |
- Berlin, Johan, 1975-, et al.
(author)
-
The dominance of mechanistic behaviour : A critical study of emergency exercises
- 2013
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In: International Journal of Emergency Management. - 1471-4825 .- 1741-5071. ; 9:4, s. 327-350
-
Journal article (peer-reviewed)abstract
- In this paper, the focus is on emergency exercises between the police, rescue services and ambulance. By practising, it is assumed that the conditions improve for a quick normalisation after an incident. The purpose of this paper is to identify whether the exercises are designed after organic action logic and therefore can be assumed to strengthen the ability to handle emergencies. Data have been collected at two large, regional, full-scale exercises (2008 and 2012). Data collection has been done through observations and document studies. The study shows that mechanistic behaviour is quite prevalent in the two studied exercises. They are time consuming and put little emphasis on practising organic behaviour. Too complex exercise scenarios contribute to a low tempo, long waiting periods and slow implementation. To succeed, the exercises need to have a non-linear time sequence and limited scenarios that invite participants to focus on organisational interfaces.
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| 48. |
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| 49. |
- Berlin, Johan, 1975-, et al.
(author)
-
The Three-Level Collaboration Exercise : Impact of Learning and Usefulness
- 2015
-
In: Journal of Contingencies and Crisis Management. - : Wiley. - 0966-0879 .- 1468-5973. ; 23:4, s. 257-265
-
Journal article (peer-reviewed)abstract
- The aim of the study was to examine the emergency personnel’s perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other’s tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasi-experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).
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| 50. |
- Berlin, Johan, 1975-, et al.
(author)
-
The yellow line : a critical study of the symbolic value of artefacts in health care teams
- 2010
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In: Cognition, Technology & Work. - : Springer Science and Business Media LLC. - 1435-5558 .- 1435-5566. ; 12:4, s. 251-261
-
Journal article (peer-reviewed)abstract
- Artefacts reveal an organisation's ''inner life'' and they contribute to its image and reputation. They also play a decisive role for an organisation's development. In this article, similar artefacts from two different health care teams—a trauma team and a psychiatric team—in the same hospital, are compared. The team members were interviewed and their work observed over the course of several years. It was demonstrated that identical pieces of equipment in a trauma team and a psychiatric team signalled opposite values. The psychiatric team was backwardlooking, conservative and contradictory. Modern technology and pieces of equipment were associated with an abandoned and previously criticised activity. The corresponding equipment in the trauma team, on the other hand, signalled a forward looking, developing and unified culture. The trauma team was a relatively new and powerfully idealised phenomenon, which attracted attention. The analysis points out how the symbolic values signal that one activity is attractive and pleasing while another has a low external legitimacy.
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