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Available. Open Access. Open Access
Article
Publication date: 1 April 2024

Annika Eklund and Maria Skyvell Nilsson

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in…

509

Abstract

Purpose

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.

Design/methodology/approach

An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.

Findings

The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.

Originality/value

This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Available. Open Access. Open Access
Article
Publication date: 22 November 2024

Mia Björk, Annika Eklund, Maria Skyvell Nilsson and Viola Nyman

The aim of this study was to identify and describe the collaborative and professional boundary challenges at a hospital ward from a bottom-up perspective.

102

Abstract

Purpose

The aim of this study was to identify and describe the collaborative and professional boundary challenges at a hospital ward from a bottom-up perspective.

Design/methodology/approach

The study was conducted as a bottom-up improvement project at a hospital ward in western Sweden. An insider action research (IAR) approach was used during the project. The theoretical framework for this project was based on the Cultural-Historical Activity Theory (CHAT). Data were collected between 2019 and 2021.

Findings

The findings showed that unclear professional boundaries and limited resources challenged and hindered interprofessional collaboration. The project group had to reorganize its daily work to adjust to the different disciplines’ legal responsibilities in relation to the patients’ recovery process. To safely discharge patients, the professionals needed to talk about each other’s professional responsibilities, professional boundaries and ethical codes.

Originality/value

The IAR project revealed that revising the daily team-round routine improved the status of assistant nurses and encouraged physicians to consider input from all professions during the patients’ recovery process. However, the new approach faced resistance from clinic leadership, who believed it could prolong patients’ stays in the ward. The findings underscore the challenges of modifying hierarchical structures and social orders within hospital settings.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Available. Open Access. Open Access
Article
Publication date: 24 October 2022

Annika Eklund, Sofia Karlsson and Lina Gyllencreutz

Major incidents in tunnel environment will pose several challenges for the emergency service organisations in terms of heat, visibility and lack of experiences from working in…

791

Abstract

Purpose

Major incidents in tunnel environment will pose several challenges for the emergency service organisations in terms of heat, visibility and lack of experiences from working in confined environments. These aspects, in turn, could pose challenges to establish collaboration. This study aims to contribute to the field of collaborative tunnel responses by exploring how “common knowledge” (Edwards, 2011) is built by the emergency services organisations, that is, what the organisations consider important while working on a potentially common problem, and their motives for the interpretations and actions if a major tunnel incident occurs.

Design/methodology/approach

Participants from the road traffic control centre, emergency dispatch centre, emergency medical service, rescue service and police were included in the study. Data from four focus group sessions was analysed using thematic analysis.

Findings

The study revealed that the tunnel environment presents specific aspects of how common knowledge was produced related to lifesaving and safety. The themes structuring mechanisms to reduce uncertainty, managing information for initial priorities, aligning responsibilities without hampering each other's work and adjusting actions to manage distance, illustrated how common knowledge was produced as crucial aspects to a collaborative response. Organising management sites, grasping and communicating risks, accessing the injury victims, was challenged by the confined environment, physical distances and imbalance in access to information and preparedness activities in tunnel environments.

Originality/value

This study offers new insights of common knowledge, by illustrating a motive perspective on collaborative responses in tunnel incidents. Creating interoperability calls not just for readiness for action and tunnel safety, but also training activities acknowledging different interpretations and motives to further develop tunnel responses.

Details

International Journal of Emergency Services, vol. 12 no. 2
Type: Research Article
ISSN: 2047-0894

Keywords

Available. Content available
Article
Publication date: 18 July 2023

Paresh Wankhade

181

Abstract

Details

International Journal of Emergency Services, vol. 12 no. 2
Type: Research Article
ISSN: 2047-0894

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Article
Publication date: 21 March 2016

Pernilla Lindskog, Annika Vänje, Åsa Törnkvist and Jörgen Eklund

– This paper aims to identify conditions affecting sustainability of Lean implementations in Swedish psychiatric healthcare, from a socio-technical perspective.

446

Abstract

Purpose

This paper aims to identify conditions affecting sustainability of Lean implementations in Swedish psychiatric healthcare, from a socio-technical perspective.

Design/methodology/approach

Longitudinal focus group interviews were conducted with 24 first-line managers within Swedish psychiatric healthcare. The analysis was made using Cherns’ ten socio-technical principles and a framework for sustainable development work in healthcare.

Findings

The most critical socio-technical principles for a sustainable Lean implementation were boundary location; power and authority; and compatibility. At hospital level, socio-technical principles were inhibited by the weak ownership of the Lean implementation. However, strong ownership at division level meant the same principles were supported. Unclear goals made follow-ups difficult which had negative effects on the learning processes in the Lean implementation. The role and responsibility of first-line managers were unclear in that they perceived they lacked power and authority resulting in negative effects on the participation – an important sustainability concept.

Originality/value

Empirically based papers assessing Lean implementations in psychiatry are rare. This study is a contribution to the research area of sustainable Lean implementations in healthcare. The practical implication of this study is that decision makers, senior managers, first-line managers and psychiatrists can be supported in reaching sustainable implementations of Lean.

Details

International Journal of Quality and Service Sciences, vol. 8 no. 1
Type: Research Article
ISSN: 1756-669X

Keywords

Available. Open Access. Open Access
Article
Publication date: 25 July 2024

Märt Vesinurm, Inka Sylgren, Annika Bengts, Paulus Torkki and Paul Lillrank

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and…

767

Abstract

Purpose

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.

Design/methodology/approach

The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.

Findings

PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.

Research limitations/implications

This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.

Practical implications

We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.

Originality/value

Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.

Available. Open Access. Open Access
Article
Publication date: 11 February 2025

Koraljka Golub and Daniel Ocic Ihrmark

Many end users turn to Google Books and social tagging services to identify books of interest. How successful they are will depend on subject indexing applied in these services…

16

Abstract

Purpose

Many end users turn to Google Books and social tagging services to identify books of interest. How successful they are will depend on subject indexing applied in these services (among other factors). The study aimed to determine: (1) to what degree are Queerlit books identified as LGBTQ+ books in widely used information services, in particular Google Books, LibraryThing and Goodreads; and, (2) whether metadata in these information services could be considered of value for the Queerlit database and complement its highly extensive and highly specific indexing.

Design/methodology/approach

The study compared keywords (subject index terms, tags) assigned to works of Swedish LGBTQ+ fiction across three commercial services: Google Books, Goodreads and LibraryThing, against the curated database, Queerlit.

Findings

Of the 1320 LGBTQ+ works in Queerlit, only a small portion was found in the three web services: 8.26% on Google Books (n = 109), 13.26% on Goodreads (n = 175), while about half on LibraryThing (55.3%, n = 730). This underrepresentation of Swedish LGBTQ+ works in the three international commercial information services makes them hardly of value to the readers. This is exacerbated by the fact that only a minority of Queerlit books found in the three services are categorised as LGBTQ+. The Queerlit database might benefit from consulting social tagging services when indexing both LGBTQ+ specific and general themes.

Originality/value

No earlier study compared in a systematic manner four different information retrieval systems and identified challenges as well as potential benefits in relation to finding LGBTQ+ fiction.

Details

Journal of Documentation, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0022-0418

Keywords

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Article
Publication date: 8 November 2011

Annika Haugen and Johan Mattsson

In Norway the most critical effects of climate change are predicted to be increased rain and snow, higher temperatures, increased wind loads, and sea‐level rise. This will…

1467

Abstract

Purpose

In Norway the most critical effects of climate change are predicted to be increased rain and snow, higher temperatures, increased wind loads, and sea‐level rise. This will increase the number of floods and landslides, along with more cycles around the freezing point and increased exposure to high moisture. The main issue for protecting Norway's historical monuments from climate change is how to be aware of and how to handle the coming problems. One challenge is to define and give this information to heritage owners and local authorities. The purpose of this paper is to describe some of the practical threats related to climate change, and provide suggestions for mitigation and adaption strategies.

Design/methodology/approach

Theoretical information of the problem is useful at a general level, but the practical impact has to be used at a local level. Improved knowledge about the risks for deterioration at different exposure levels, thorough surveys, and practical solutions, can significantly reduce the negative effects. This knowledge must reach the people that have local and daily contact with the cultural heritage. Information to the owners and responsible authorities about the normal risk of deterioration and how to identify risks related to climate change is crucial.

Findings

The main results of the authors' work is a methodology dealing with the problem step‐by‐step production of a web‐site based on fact sheets for heritage owners and managers. The fact sheets are divided amongst different subjects and are designed to be informative and easy to use for owners and responsible authorities.

Originality/value

The results presented in this paper will increase the knowledge of how owners of cultural heritage can be prepared for climate change on a practical, hands‐on level. This can, for example, be done by a brief overall analysis of the threats of the cultural heritage in a specific municipality. The analysis can be summarised in a list of increased possible risks, with direct practical information given to those needing it, and placed online. This would enable detection of and reaction to warning signs of an unusual situation. Information, training and production of both general and specific plans for action in case of extreme situations are also important in order to prevent the negative effects of climate change.

Details

International Journal of Climate Change Strategies and Management, vol. 3 no. 4
Type: Research Article
ISSN: 1756-8692

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