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1 – 4 of 4Mattias Elg, Jesper Stenberg, Peter Kammerlind, Sofia Tullberg and Jesper Olsson
The purpose of this paper is to empirically examine developmental trends in healthcare organisation management practice and improvement work.
Abstract
Purpose
The purpose of this paper is to empirically examine developmental trends in healthcare organisation management practice and improvement work.
Design/methodology/approach
Primary healthcare centre (n=1,031) and clinical hospital department (n=1,542) managers were surveyed in spring 2007 (response rate 46 per cent). This article compares results from this survey with a study in 2003. A theoretical framework based on organisational inner context, organisational outer context, external environment and outcomes form the analytical base. Comparisons were made using independent two‐sample t‐tests.
Findings
A general aspect, identified empirically, is the tendency toward increased external pressure on leaders in their improvement work. Higher management decisions, patient pressure and decisions made by policymakers increasingly influence and shape the choices made by healthcare managers about where to focus improvement efforts. Three different trends are empirically identified and elaborated: take‐control logic; practice‐based improvement; and patient‐centeredness.
Research limitations/implications
Healthcare leaders should carefully design new management control systems that support healthcare micro systems. Findings support the general assumption that staff increasingly tend to focus organisational changes on management control.
Originality/value
This study extends management research with a unique survey. Through two measurements made in 2003 and 2007, several important trends about how healthcare organisations are managed and developed are identified.
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Mattias Elg, Lars Witell, Bozena Poksinska, Jon Engström, Su Mi Dahlgaard‐Park and Peter Kammerlind
The purpose of this paper is to develop an understanding of how patients experience their health problems and how they can generate innovative ideas about health care services…
Abstract
Purpose
The purpose of this paper is to develop an understanding of how patients experience their health problems and how they can generate innovative ideas about health care services. The research questions that guide the present study are: how can solicited diaries be used for capturing patient ideas? What type of data is generated from solicited diaries used for generating patient ideas? And what are the potential benefits and shortcomings of using patient diaries in generating ideas for improvement of health care services?
Design/methodology/approach
The paper is based on an exploratory case study using patient diaries to solicit ideas about how health care services in Sweden can be improved. From the methodological viewpoint, the diaries are used as a tool for patient co‐creation of health care services.
Findings
When analyzing dairies written by patients four different types of diaries emerged from the study: brief, reporting, descriptive and reflective diaries. Furthermore, 102 ideas for improvements within nine areas were identified from the contents of dairies.
Research limitations/implications
Adopting patients' diaries as a way to activate and promote co‐creation of values is at an embryo stage, and hence more research is needed.
Originality/value
One of the strengths of the paper includes its potential for practical implications, either clinical or methodological, by using patients' dairies. It focuses both on the content generated from the diaries for improving health services, as well as the use of the diaries for practicing the idea of patients as co‐creators in health care service.
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Quality improvement has developed and spread, and today, all Swedish Regions emphasize that their strategies are based on systematic improvement. This paper aims to describe and…
Abstract
Purpose
Quality improvement has developed and spread, and today, all Swedish Regions emphasize that their strategies are based on systematic improvement. This paper aims to describe and illuminate the development of Quality Improvement (QI) in Swedish healthcare and welfare organizations by using publications in a Swedish context.
Design/methodology/approach
The overview synthesis is inspired by a scoping literature review approach of relevant literature. All publications relevant to Swedish healthcare and welfare settings between 1992 until 2020 were included.
Findings
In all, 213 papers, 29 books and chapters and 34 dissertations related to QI and research in Swedish healthcare and welfare context were identified. From 2011 to 2020, the publication rate increased rapidly. Six different focus areas emerged: systematic and value-creating improvement work; collaboration between organizations and healthcare providers; use of improvement methods and (theoretical) models; leadership and learning; measurements, quality registers and follow-up; and involvement and patient safety. Further QI development in Swedish healthcare and welfare points to an increased importance of collaboration between organizations and coproduction with beneficiaries for the healthcare and welfare services.
Originality/value
This paper is one of the first to describe and illuminate the QI development in the healthcare and welfare sector in a country. The trajectory also points to a need for coproduction to handle future challenges.
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The purpose of this paper is to explore what motivates patients to participate in service development and how participation may influence their well-being. Health-care providers…
Abstract
Purpose
The purpose of this paper is to explore what motivates patients to participate in service development and how participation may influence their well-being. Health-care providers are increasingly adopting practices of customer participation in such activities to improve their services.
Design/methodology/approach
This paper builds on an analysis of data from a service development project in which lung cancer patients contributed by sharing their ideas and experiences through diaries. Out of the 86 lung cancer patients who were invited to participate, 20 agreed to participate and 14 fully completed the task. The study builds on participants’ contributions, in-depth interviews with six participants and the reasons patients gave for not participating.
Findings
This paper identifies a number of motives: non-interest in participating, restitution after poor treatment, desire for contact with others, volunteerism, desire to make a contribution and the enjoyment of having a task to complete. A self-determination theory perspective was adopted to show how the need to satisfy basic human needs for autonomy, competence and relatedness determines if and how patients participate. Participation may have important benefits for patients, especially an improved sense of relatedness.
Practical implications
Service providers must be prepared to meet different patient needs in service development, ranging from the need to express strong distress to expressing creativity. By understanding the dynamics of motivation and well-being, organizers may achieve better results in terms of improved services and in patient well-being.
Originality/value
This study makes a significant contribution to the study of customer participation in service development, especially in relation to health care, by offering a self-determination-based typology for describing different styles of patient participation.
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