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Article
Publication date: 1 January 2016

Fredrik Bååthe, Gunnar Ahlborg Jr, Lars Edgren, Annica Lagström and Kerstin Nilsson

The purpose of this paper is to uncover paradoxes emerging from physicians’ experiences of a patient-centered and team-based ward round, in an internal medicine department.

Abstract

Purpose

The purpose of this paper is to uncover paradoxes emerging from physicians’ experiences of a patient-centered and team-based ward round, in an internal medicine department.

Design/methodology/approach

Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings.

Findings

This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician’s professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician’s professional identity was centered. Physicians with more of an I-perspective experienced challenges with the new round, while physicians with more of a We-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered.

Practical implications

For change processes affecting physicians’ professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure.

Originality/value

This paper provides increased understanding about how physicians’ professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement.

Details

Leadership in Health Services, vol. 29 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 27 January 2012

Lars Edgren and Keith Barnard

The purpose of this paper is to examine how a complex adaptive systems (CAS) approach can be used to promote the integration of health and social care for the benefit of the user.

2235

Abstract

Purpose

The purpose of this paper is to examine how a complex adaptive systems (CAS) approach can be used to promote the integration of health and social care for the benefit of the user.

Design/methodology/approach

This paper is a research review and a conceptual analysis of key issues identified in the growing literature on CAS. An application of the CAS approach to the field of integrated care is presented. The paper identifies crucial issues, notably: bringing together different providers and the place of the user as a co‐producer of care.

Findings

The benefits of the CAS approach to integrated care are distilled. Above all CAS provides managers of health and social care with an alternative mindset. Guiding principles are offered to these managers to facilitate development towards a more integrated system of health and social care. The possibility to benefit from the user's own resources is increased when organizations are viewed from a CAS perspective. CAS promotes emergent ways of working.

Practical implications

The CAS approach makes possible a significant improvement in relationships between providers and users and managers and providers; a possibility of more productive relationships and better care outcomes, not least in terms of user satisfaction.

Originality/value

The paper shows that CAS literature applied to the health and social care field points the way for managers to rethink the functioning of the field, specifically to go beyond the present dominant but outdated machine model to one which encourages the cooperation of providers and users for better outcomes.

Details

Leadership in Health Services, vol. 25 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 15 June 2015

Lars Edgren and Keith Barnard

The purpose of this paper is to contribute to knowledge by exploring and distilling how providers in health and social care who have adopted complex adaptive systems thinking (CAS…

Abstract

Purpose

The purpose of this paper is to contribute to knowledge by exploring and distilling how providers in health and social care who have adopted complex adaptive systems thinking (CAS thinking) and have a collaborative mindset are in a better position to achieve integrated care than those who adopt reductionist approaches.

Design/methodology/approach

This paper is a research review and a conceptual analysis of key aspects drawn from the literature on CAS thinking and collaborative mindset applied to integrated care. By choosing this approach the authors intend to promote understanding and efforts made to put it into action. The intended audience comprises managers responsible for addressing the problem of fragmentation and the research community challenged by the task of supporting those managers.

Findings

Specialization of knowledge and skill has increased the risk of fragmentation. It is possible to reduce that risk and hence to foster integrated care when providers with different specializations stimulated by a collaborative mindset develop an understanding of how they connect with others in a CAS. The essence of CAS thinking applied to integrated care is the readiness to connect. This readiness is facilitated by adopting a collaborative mindset.

Originality/value

Literature on CAS thinking and collaborative mindset have evolved independently of one another. The study points at the importance of connecting the two concepts to produce effective action.

Article
Publication date: 1 April 1989

Lars Edgren

It is maintained that Scandinavian management is becoming a concept with substance. It may seem somewhat peculiar for a Scandinavian business consultant to continue the search for…

Abstract

It is maintained that Scandinavian management is becoming a concept with substance. It may seem somewhat peculiar for a Scandinavian business consultant to continue the search for ideas and inspiration in some of the most successful companies in the USA.

Details

Management Research News, vol. 12 no. 4/5
Type: Research Article
ISSN: 0140-9174

Article
Publication date: 1 August 2007

Alison Petch

Abstract

Details

Journal of Integrated Care, vol. 15 no. 4
Type: Research Article
ISSN: 1476-9018

Content available
Article
Publication date: 15 June 2015

Robin Miller, Jon Glasby and Sue White

135

Abstract

Details

Journal of Integrated Care, vol. 23 no. 3
Type: Research Article
ISSN: 1476-9018

Content available
Article
Publication date: 27 January 2012

Jennifer Bowerman

364

Abstract

Details

Leadership in Health Services, vol. 25 no. 1
Type: Research Article
ISSN: 1751-1879

Open Access
Book part
Publication date: 4 October 2023

Laura Korhonen, Linnéa Lindholm, Maria Lindersson and Ann-Charlotte Münger

Swedish society has systematically worked to improve children's health and well-being since the early twentieth century and is considered a leading figure globally in battling…

Abstract

Swedish society has systematically worked to improve children's health and well-being since the early twentieth century and is considered a leading figure globally in battling violence against children. Awareness of violence against children and its detrimental effects on development and health is generally high in Sweden. Violence is also broadly recognised as a violation of human rights. A ban on corporal punishment was enacted in 1948 in social childcare institutions, in 1958 in schools, and in 1979 at home. The more recent landmark was the United Nations Convention on the Rights of the Child, established as law on 1 January 2020. In line with convention's Article 12, stating that a child has the right to express their views in all matters affecting them, more attention to child participation has been paid since 2020. This chapter provides several recent examples of strategic measures that have been used to enhance child participation in governmental assignments and enquiries and state-funded research. We discuss the examples considering the United Nations convention and child participation methods and pinpoint opportunities and obstacles to further develop and consolidate child participation as a norm in publicly funded societal activities.

Details

Participatory Research on Child Maltreatment with Children and Adult Survivors
Type: Book
ISBN: 978-1-80455-529-3

Keywords

Book part
Publication date: 2 July 2020

May-Len Skilbrei

Feminist criminologists are well acquainted with how their research on sexual harms and gendered forms of victimisation may serve as powerful levers for punitive agendas. In…

Abstract

Feminist criminologists are well acquainted with how their research on sexual harms and gendered forms of victimisation may serve as powerful levers for punitive agendas. In recent years, culturalist interpretations of sexual violence have become key themes in debates on migration and integration in liberal welfare democracies, such as Denmark, Norway and Sweden. In this, complex issues of gender, ethnicity and power are involved, and the balancing of these, both analytically and ethically, poses a challenge to feminists in their attempts to contribute to social change. This chapter will, based on examples from debates in Sweden, present and discuss how argumentation about sexual freedom and integrity is enlisted in attempts to reinforce borders and ideas about dangerous Others, and outline how a fruitful meeting between criminology and feminism can advance the scholarship on sexual violence.

Details

The Emerald Handbook of Feminism, Criminology and Social Change
Type: Book
ISBN: 978-1-78769-956-4

Keywords

Article
Publication date: 11 January 2016

Rocco Palumbo

The purpose of this paper is to contextualize the concepts of “service co-production” and “value co-creation” to health care services, challenging the traditional bio-medical…

5736

Abstract

Purpose

The purpose of this paper is to contextualize the concepts of “service co-production” and “value co-creation” to health care services, challenging the traditional bio-medical model which focusses on illness treatment and neglects the role played by patients in the provision of care.

Design/methodology/approach

For this purpose, the author conducted a systematic review, which paved the way for the identification of the concept of “health care co-production” and allowed to discuss its effects and implications. Starting from a database of 254 records, 65 papers have been included in systematic review and informed the development of this paper.

Findings

Co-production of health care services implies the establishment of co-creating partnerships between health care professionals and patients, which are aimed at mobilizing the dormant resources of the latter. However, several barriers prevent the full implementation of health care co-production, nurturing the application of the traditional bio-medical model.

Practical implications

Co-production of health care is difficult to realize, due to both health care professionals’ hostility and patients unwillingness to be involved in the provision of care. Nonetheless, the scientific literature is consistent in claiming that co-production of care paves the way for increased health outcomes, enhanced patient satisfaction, better service innovation, and cost savings. The establishment of multi-disciplinary health care teams, the improvement of patient-provider communication, and the enhancement of the use of ICTs for the purpose of value co-creation are crucial ingredients in the recipe for increased patient engagement.

Originality/value

To the knowledge of the author, this is the first paper aimed at systematizing the scientific literature in the field of health care co-production. The originality of this paper stems from its twofold relevance: on the one hand, it emphasizes the pros and the cons of health care co-production and, on the other hand, it provides with insightful directions to deal with the engagement of patients in value co-creation.

Details

International Journal of Public Sector Management, vol. 29 no. 1
Type: Research Article
ISSN: 0951-3558

Keywords

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