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1 – 9 of 9Lilly-Mari Sten, Pernilla Ingelsson, Ingela Bäckström and Marie Häggström
Team collaboration is essential to ensure the quality of care and patient safety when critically ill patients are transferred from an intensive care unit (ICU) to a general ward…
Abstract
Purpose
Team collaboration is essential to ensure the quality of care and patient safety when critically ill patients are transferred from an intensive care unit (ICU) to a general ward. Measuring team collaboration in the patient transfer process can help gain insights into how team collaboration is perceived and how it can be improved. The purpose of this paper is to describe the development and testing of a questionnaire aiming to measure perceived team collaboration in the patient transfer process from ICU to the general ward. This study also aims to analyze the results to see how the survey could help improve team collaboration within ICU transitional care.
Design/methodology/approach
Statements, factors and main areas intended to measure perceived team collaboration were developed from a theory. The questionnaire was tested in two ICUs at two hospitals located in Sweden, and the results were analyzed statistically.
Findings
The results showed that the questionnaire could be used for measuring perceived team collaboration in this process. The results from the survey gave insights that can be useful when improving team collaboration in ICU transitional care.
Research limitations/implications
The collaboration between two research subjects, Nursing Science and Quality Management, has given new perspectives in how cultural and systemic differences and opportunities can help improving team collaboration in ICU transitional care, by shifting focus from the individual to team, culture, system, process and continuous improvement.
Practical implications
The developed questionnaire can be used to measure perceived team collaboration and to identify areas for improving team collaboration in the ICU transitional care process.
Originality/value
There is a sparse amount of research about measuring team collaboration in ICU transitional care, and this study contributes to filling this research gap.
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Lilly-Mari Sten, Pernilla Ingelsson, Ingela Bäckström and Marie Häggström
The purpose of this literature review was to explore to what extent quality management (QM) and nursing science offer complementary perspectives to provide better quality care, by…
Abstract
Purpose
The purpose of this literature review was to explore to what extent quality management (QM) and nursing science offer complementary perspectives to provide better quality care, by looking at QM core concepts and tools.
Design/methodology/approach
A systematic literature review was conducted. Papers published in academic journals between January 2013 and December 2019 were included. A deductive content analysis was chosen using QM core values as an analytical framework.
Findings
The results showed that QM core values, methodologies and tools were found in the reviewed articles about intensive care unit (ICU) transitional care. The results indicated that core values in QM and the core competencies within nursing science in ICU transitional care are mutually dependent upon each other and exist as a whole. ICU transitional care is, however, a complex interpersonal process, characterized by differences in organizational cultures and core values and involving multidisciplinary teams that collaborate across hospital units. The QM core value that was least observed was committed leadership.
Research limitations/implications
Combining QM and nursing science can contribute to a deeper understanding of how to improve the ICU transitional care process by bringing complementary perspectives.
Practical implications
The included articles portray how QM is applied in ICU transitional care. Implications for future research focus on enhancing the understanding of how QM and nursing science can bring complementary perspectives in order to improve ICU transitional care and how QM values, methodologies and tools can be used in ICU transitional care. Committed leadership and team collaboration in ICU transitional care are areas that call for further research.
Originality/value
The findings contribute to the body of literature by providing important insights in terms of how QM core values, methodologies and tools are present in research about ICU transitional care and how the two research subjects, namely, QM and nursing science, bring complementary perspectives.
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Ingela Bäckström, Pernilla Ingelsson, Lilly-Mari Sten and Marie Häggström
The purpose of this study is to develop a model describing different factors that affect quality and efficiency in transitional care.
Abstract
Purpose
The purpose of this study is to develop a model describing different factors that affect quality and efficiency in transitional care.
Design/methodology/approach
A meta-synthesis focusing on the transitions between wards was conducted within a research project. The results from eight studies within that research project have been combined and analysed from a holistic view.
Findings
The findings are a model with a description of seven different categories consisting of the identified factors affecting quality and efficiency in transitional care. Those categories are (1) learning organisation, (2) standardising and structuring, (3) applying a holistic view, (4) understanding organisational culture in a health care context, (5) management and leadership, (6) for whom value is created and (7) working together. The results from the study have been verified in previous research.
Research limitations/implications
The result of the completed meta-synthesis is based on studies conducted at two medium-sized hospitals in Sweden. The developed model can be used in a similar context to improve quality and efficiency in patient transfers by management and employees working based on the various factors.
Originality/value
This model describes factors (success factors, prerequisites, conditions and lack thereof) affecting the ability to achieve quality and efficiency in transitional care that can be used in future research as well as for practical improvements.
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Lisabet Wieslander, Ingela Bäckström and Marie Häggström
The purpose of this review is to identify how health professionals perceive participation in implementation of new technology in healthcare organizations.
Abstract
Purpose
The purpose of this review is to identify how health professionals perceive participation in implementation of new technology in healthcare organizations.
Design/methodology/approach
A qualitative systematic review based on the PRISMA diagram, was conducted using qualitative synthesis. NVivo software was used for thematic analysis. The searches were performed in PubMed, CINAHL and Scopus.
Findings
A total of 15 articles were included in the review, four themes describing how participation of health professionals in digital transformation affects the outcomes were identified, and three themes describing the factors that are necessary to promote participation. The underlying latent theme of an unmet desire to participate in the digital transformation was also identified in the analysis.
Originality/value
The digital transformation of healthcare is complex and faces many obstacles if not managed correctly. Professional participation in the implementation seems to be essential for success. Focus on increased resources and planning during early stages, as well as teamwork and ethical reflection is important addressing the challenges that professionals face in digital transformation of healthcare.
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Lilly-Mari Sten, Pernilla Ingelsson and Marie Häggström
The purpose of this paper is to describe the perception of real teamwork and sustainable quality culture as well as success factors for achieving a sustainable quality culture…
Abstract
Purpose
The purpose of this paper is to describe the perception of real teamwork and sustainable quality culture as well as success factors for achieving a sustainable quality culture within an organisation, focusing on top management teams (TMTs). An additional purpose is to explore the relationship between real teamwork and sustainable quality culture.
Design/methodology/approach
A mixed-methods design focusing on TMTs was used. Four TMTs were open-sampled and located in different parts of Sweden. The data were collected through questionnaires and focus group discussions between April 2022 and December 2022. Follow-up meetings were thereafter held with the participants. A meta-analysis was conducted of the data from the four TMTs.
Findings
Two overarching conclusions of this study were: to follow the developed methodology can be one way to increase TMTs' abilities for real teamwork alongside a sustainable quality culture, and the results also showed the importance of a systems view, emotional commitment and continuous improvement for improving real teamwork and creating a sustainable quality culture.
Practical implications
Practical implications were suggestions on how to increase the TMTs' abilities for real teamwork alongside a sustainable quality culture. A deepened understanding of real teamwork and a sustainable quality culture was also achieved by the participants.
Originality/value
The novelty of this paper is the use of a new methodology for assessing teamwork and sustainable quality culture. To the authors' knowledge, no similar research has previously been performed to investigate teamwork alongside a sustainable quality culture, focusing on TMTs.
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Lilly-Mari Sten, Pernilla Ingelsson and Marie Häggström
The purpose was to present a developed, tested and evaluated methodology for assessing teamwork and sustainable quality culture, focusing on top management teams (TMTs).
Abstract
Purpose
The purpose was to present a developed, tested and evaluated methodology for assessing teamwork and sustainable quality culture, focusing on top management teams (TMTs).
Design/methodology/approach
The developed methodology was based on a convergent mixed-method design, including two data collection methods: questionnaire and focus group discussion. Two pilot tests were performed with two TMTs. This design involved analysing, merging and interpreting data, first separately by data collection method and theme and then in a meta-interpretation. Lastly, there was a follow-up meeting for evaluating results.
Findings
Findings from the study were that the methodology can be used to assess teamwork and sustainable quality culture, and the results also showed the strength of using two data collection methods to provide a broader picture of teamwork and sustainable quality culture. A follow-up meeting validated the results and provided additional value to the two TMTs in the form of suggestions on how to improve their teamwork and sustainable quality culture.
Practical implications
Applying this methodology can guide TMTs in how to improve their teamwork and sustainable quality culture within their organisations.
Originality/value
This is a new methodology, containing a developed questionnaire and an interview guide, aiming to assess and evaluate teamwork within TMTs and sustainable quality culture. The practice of the methodology adds value to both TMTs and their organisations, as well as provides a theoretical and methodological contribution to research on teamwork and sustainable quality culture.
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Marie Häggström, Kenneth Asplund and Lisbeth Kristiansen
Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of…
Abstract
Purpose
Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of quality of care during a patient's transfer process from an intensive care unit to a general ward.
Design/methodology/approach
The study had a mixed method design that included quantitative data and answers to open questions. The participants were 65 relatives of patients who received care in an ICU. They were recruited from two hospitals in Sweden.
Findings
A majority perceived the transfer process as important, but analysis also showed that the participants rated it as an area for improvements. The relatives wanted participation, personal insight and control, respectful encounters, proximity, reassurance, continuous quality, reconnection and feedback. The relatives' participation in the transfer process was perceived as inadequate by 61 per cent, and the support that was received after the ICU discharge was perceived as inadequate by 53 per cent. The patients' length of stay in the ICU affected the relatives' perceptions of the quality of care. Overall, the relatives seemed to desire that the transfer process includes a continuous care, a competent staff, available information throughout the transfer process and personal involvement in the care, both before and after the transfer from the ICU.
Research limitations/implications
The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.
Practical implications
The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.
Originality/value
The findings have important implications for nursing and nursing management. A relative's perception of the quality of care before and after transfer from ICU may be a valuable source to evaluate the ICU transitional care.
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Nikolaos Efstathiou, Anna Lock, Suha Ahmed, Linda Parkes, Tammy Davies and Susan Law
Following the development of a service that consisted of a “single point of contact” to coordinate end-of-life care (EoLC), including EoLC facilitators and an urgent response…
Abstract
Purpose
Following the development of a service that consisted of a “single point of contact” to coordinate end-of-life care (EoLC), including EoLC facilitators and an urgent response team, we aimed to explore whether the provision of coordinated EoLC would support patients being cared or dying in their preferred place and avoid unwanted hospital admissions.
Design/methodology/approach
Using a realist evaluation approach, the authors examined “what worked for whom, how, in what circumstances and why”. Multiple data were collected, including activity/performance indicators, observations of management meetings, documents, satisfaction survey and 30 interviews with service providers and users.
Findings
Advance care planning (ACP) increased through the first three years of the service (from 45% to 83%) and on average 74% of patients achieved preferred place of death. More than 70% of patients avoided an emergency or unplanned hospital admission in their last month of life. The mechanisms and context identified as driving forces of the service included: 7/7 single point of contact; coordinating services across providers; recruiting and developing the workforce; understanding and clarifying new roles; and managing expectations.
Research limitations/implications
This was a service evaluation and the outcomes are related to the specific context and mechanisms. However, findings can be transferable to similar settings.
Practical implications
“Single point of contact” services that offer coordinated EoLC can contribute in supporting people to be cared and die in their preferred place.
Originality/value
This paper provides an evaluation of a novel approach to EoLC and creates a set of hypotheses that could be further tested in similar services in the future.
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