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Quality Improvement in Healthcare
No full textABSTRACT
The Swedish healthcare system, although being one of the more efficient
care systems in the world with good medical outcomes at a moderate cost,
faces tremendous future challenges. An ageing population with more
patients suffering from multiple diseases together with accelerating medicotechnical developments is putting increasing pressure on the system. The quality and safety of the system has also been called into question.
Improvement science, where quality improvement theories and practices are
continuously being translated to a healthcare context, has emerged as one
possible solution to these challenges. However, there is need for a further
theoretical and practical development of the field.
The purpose of the thesis is to explore quality improvement initiatives in
healthcare systems, suggesting alternative ways of improving quality and
efficiency in healthcare organizations. The empirical material draws on
leveraging events during two long-term improvement initiatives in the
healthcare system of Skaraborg in the Western region of Sweden. The
author, working as a development director at the Skaraborg hospital group
(SkaS), played a major role in both cases as an inside action researcher. The
first case addresses a decade of development efforts that sought to improve
care for elderly people in West Skaraborg. The second case explores how
quality management ideas at SkaS were used to improve quality, efficiency
and safety in hospital care from 2006 to 2008.
The results of the research draw special attention to the importance of
moving beyond the established static, linear step-for-step models for quality
improvement, instead embracing a more open and processual view on
improvement. The thesis proposes that practices and theories from the
action research (AR) field in this respect are useful complements to the
emerging field of improvement science. AR practices entail an approach that
enhances joint learning and reflection in iterative action-reflection cycles.
Further, drawing from the vast repertoire of AR practices, cognitive,
structural, networking, and procedural learning mechanisms are vital
ingredients for quality improvement in complex healthcare systems.
Learning mechanisms connect all parts of the system but they also support
individual and organizational learning and action through new vocabularies,
frameworks and concepts, procedures and tools
Quality Improvement in Healthcare [Elektronisk resurs]
No full textABSTRACTThe Swedish healthcare system, although being one of the more efficientcare systems in the world with good medical outcomes at a moderate cost,faces tremendous future challenges. An ageing population with morepatients suffering from multiple diseases together with accelerating medicotechnical developments is putting increasing pressure on the system. The quality and safety of the system has also been called into question.Improvement science, where quality improvement theories and practices arecontinuously being translated to a healthcare context, has emerged as onepossible solution to these challenges. However, there is need for a furthertheoretical and practical development of the field.The purpose of the thesis is to explore quality improvement initiatives inhealthcare systems, suggesting alternative ways of improving quality andefficiency in healthcare organizations. The empirical material draws onleveraging events during two long-term improvement initiatives in thehealthcare system of Skaraborg in the Western region of Sweden. Theauthor, working as a development director at the Skaraborg hospital group(SkaS), played a major role in both cases as an inside action researcher. Thefirst case addresses a decade of development efforts that sought to improvecare for elderly people in West Skaraborg. The second case explores howquality management ideas at SkaS were used to improve quality, efficiencyand safety in hospital care from 2006 to 2008.The results of the research draw special attention to the importance ofmoving beyond the established static, linear step-for-step models for qualityimprovement, instead embracing a more open and processual view onimprovement. The thesis proposes that practices and theories from theaction research (AR) field in this respect are useful complements to theemerging field of improvement science. AR practices entail an approach thatenhances joint learning and reflection in iterative action-reflection cycles.Further, drawing from the vast repertoire of AR practices, cognitive,structural, networking, and procedural learning mechanisms are vitalingredients for quality improvement in complex healthcare systems.Learning mechanisms connect all parts of the system but they also supportindividual and organizational learning and action through new vocabularies,frameworks and concepts, procedures and tools
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Vad skulle Habermas säga om vårddebatten?
No full textI dag fyller han 90 år, den outtröttlige filosofen och sociologen Jürgen Habermas. Som en av vår tids största tänkare har han skrivit och debatterat i över 60 år – alltid beredd att ompröva sin egen ståndpunkt. Vad hade han tyckt om den svenska sjukvårdsdebatten
Vad skulle Habermas s\ue4ga om v\ue5rddebatten?
No full textI dag fyller han 90 \ue5r, den outtr\uf6ttlige filosofen och sociologen J\ufcrgen Habermas. Som en av v\ue5r tids st\uf6rsta t\ue4nkare har han skrivit och debatterat i \uf6ver 60 \ue5r – alltid beredd att ompr\uf6va sin egen st\ue5ndpunkt. Vad hade han tyckt om den svenska sjukv\ue5rdsdebatten
Applying Process Management in Healthcare –Investigating Implementation Difficulties
No full textThis paper focuses on the meeting between a Swedish healthcare organization and the idea of process management. It is evident that the organization itself in many ways becomes an obstacle to the achievement of a process oriented management style. The empirical story that gives voices from the healthcare staff reveals conflicts about the organizing principle and structures such as budgeting and reimbursement systems - obviously built on a more functional view of an organization. It is not completely evident that the two alternative perspectives are easily able to co-exist, and managing seems to be an advanced balancing act
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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