Dissertations / Theses on the topic 'Health services innovation'
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Ziglio, Erio. "Uncertainty and innovation in health policy : the Canadian and Norwegian approaches to health promotion." Thesis, University of Edinburgh, 1985. http://hdl.handle.net/1842/19439.
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Petrich, Mark William. "Innovation in Community-Based Health Services: A Multiple Case Study Exploration." Thesis, Curtin University, 2020. http://hdl.handle.net/20.500.11937/81967.
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A qualitative multiple case study explored three cases of novel health services for people at risk of homelessness, sourcing data from interviews with 18 participants, observations and documents. Productivity was associated with outcomes, shared language and intersecting purpose. Four modes of innovation production provided organising frameworks for actions in the stages of innovation; project, political, strategic, and relational. A productive innovation establishes both cultural embeddedness and a perceived adequate contribution to the setting’s mission.
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Ferlie, E. "Efficiency improving innovation in the community care of the elderly." Thesis, University of Kent, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.370373.
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Fox, Amanda R. "Factors influencing sustainability of health service innovation, emergency nurse practitioner service." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/92994/1/Amanda_Fox_Thesis.pdf.
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Escalating health care delivery costs and consumer expectations have led to a range of health service and workforce innovations in the provision of high quality cost effective patient care. This research has operationalised a theoretical framework to examine factors that influence sustainability of health service innovations, in particular, emergency nurse practitioner service. The results of this research will inform health service policy and practice for future implementation of innovative workforce models and add to the understanding of factors that influence sustainability.
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Heaney, David. "Organisational change and remote and rural health care delivery : identifying the attributes of successful innovation." Thesis, University of Aberdeen, 2013. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=211425.
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Aims To investigate the impact of organisational change on the delivery of health services in remote and rural Scotland using, as an example, changes in the organisation of out of hours primary care, and to identify the attributes of successful innovation in remote and rural health provision. Methods The thesis comprised a thematic literature review; in depth interviews with key stakeholders, and case studies based in remote communities. Results The literature review identified recurring attributes of successful innovation. Interviews with remote and rural GPs showed that working out of hours had been, or still was, an integral part of life as a GP. Most agreed there had been an impact on family life. Advantages and challenges of remote and rural working were identified; many GPs could not envisage a better way of delivering services. This was contested by managers. There were divergent views of the 2004 GMS contract. The GPs who opted out of 24 hour responsibility experienced a transformational change in working life. All in all, there was a lack of understanding, and trust, between organisations. NHS 24 and Scottish Ambulance Service were criticised. There had been little change in out of hours service delivery since 2005, and the present configuration was seen as expensive and unsustainable. Despite these acknowledged difficulties, the view was that difficult decisions had been avoided, and a long-term solution that fits the area was required. The case studies added detail and contextual understanding of delivery of services. This could vary even within a practice area. Service delivery on islands was different, with a stronger tie between community and practice, governed by transport logistics, and difficult to understand from an outside perspective. Conclusions. The delivery of out of hours services in remote and rural Scotland has been a difficult and contested issue. Context can have different impacts, even within a very small area. Failure to innovate was associated with lack of collaboration, lack of strategy, lack of understanding of local context, and avoidance of difficult decisions. The organisational change literature demonstrated that receptive contexts for change were not present.
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Kollberg, Beata. "Performance Measurement Systems in Swedish Health Care Services." Doctoral thesis, Linköping : Department of Management and Engineering, Linköpings universitet, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9302.
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Sansourekidou, Patricia. "Accessibility of Innovative Services in Radiation Oncology." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7738.
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The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion of innovation theory was used as the theoretical framework for the study. A quantitative cross-sectional analysis was performed to assess how innovation scores may vary depending on individual and organizational factors. ANOVA, Spearman correlation, and multiple linear regression were used to analyze the data. University affiliation, urbanicity, appreciation, and motivation were found to be statistically significant factors affecting accessibility to innovative services. Statistically significant barriers preventing innovation were lack of evidence, increased complexity, staffing constraints, lack of interest from others, lack of interoperability, and lack of reimbursement. Medical physicists are in a leadership position to influence the adoption of innovative services in RO. Encouraging the utilization of innovative and Food and Drug Administration-approved techniques may improve cancer outcomes and consequently have a positive social change effect on public health.
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Roberts, Lance L. "Leadership safe practices snd their relationship with hospital deployment of the medication reconciliation innovation." Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/879.
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Within the last decade there has been considerable national attention focused upon hospital quality and patient safety performance. Improvements in performance have been realized, but the rate of improvement has been slow. There is an increasing consensus that new ideas and national strategies are needed to accelerate improvement efforts in addressing quality/safety issues. Currently, within the hospital setting more attention is being paid to the role of leadership starting with the board of trustees in addressing gaps in performance. Organization-wide awareness of critical gaps in performance, accountability structures, and organizational ability are considered critical facilitators of improvement efforts. The characteristics of awareness, accountability, ability, and action are components of a "4A" conceptual framework that is used most prominently by the National Quality Forum (NQF) in their Safe Practices for Better Healthcare toolkit to frame governance and leaderships' responsibilities in establishing leadership structures and systems to ensure the safety of patients and staff.
This study utilizes the National Quality Forum's version of the 4A model to frame an empirical examination of the relationship between leadership structure and system characteristics and hospitals' implementation of the medication reconciliation innovation. A Patient Safety, Culture, and Leadership survey was used to capture Iowa hospital CEO/Quality Leaders' perceptions of board and leadership awareness and accountability characteristics. And, on a quarterly basis since mid-2006 a separate web-based survey has captured Iowa hospital Quality Leaders' perceptions of medication reconciliation implementation.
Both cross-sectional and longitudinal analyses were conducted to examine the relationship between leadership structures and systems and hospital-wide deployment of the medication reconciliation initiative.
This study finds evidence that board-level awareness characteristics - the time the board spent in meetings on quality and safety issues, and the frequency of board receipt of a formal quality/safety report - were positively related to hospitals' early efforts to deploy the medication reconciliation initiative. Over time hospitals' financial ability was positively related to deployment of this initiative.
Further research should focus on how healthcare governance and leadership teams can use the elements of leadership structures and systems safe practices to effectively create and sustain a culture of safety.
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Njoku, Vicente. "Strategies Hospital Administrators Utilize to Optimize Patient Services." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7496.
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Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with 10 administrators, from the participants' archival documents, and from hospital archives. Interview transcripts and data from multiple hospital locations were coded and analyzed using methodological triangulation. Five themes identified from data analysis were triple-aim strategy, evidence-based practice, lean methodology, public health strategy, and innovation strategy. Implementing the appropriate strategy in each hospital setting might facilitate identification of elements that are lacking, mitigating, or slowing down the hospital improvement process. The findings of this study might contribute to positive social change by creating platforms for sharing information among patients and providers, payors, pharmacies, and policymakers.
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Wilson-Evered, Elisabeth 1956. "The leadership and workgroup requirements that organizations need to ignite and fan the flames of innovation." Monash University, Dept. of Management, 2002. http://arrow.monash.edu.au/hdl/1959.1/7899.
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Hu, Xiao Xia Public Health & Community Medicine Faculty of Medicine UNSW. "Improving quality while reducing cost : an innovation journey." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2003. http://handle.unsw.edu.au/1959.4/20464.
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Background: Many innovative ideas have been proposed to manage and improve the quality and cost of clinical care. For many innovations, like Total Quality Management (TQM), the "black box" of implementation process is not well understood. Empirical work on the process of innovation implementation in health care is limited. Objective: This study was designed to explore how one organisation, Intermountain Health Care (IHC), an acute and primary health care provider in the USA, innovates in implementing TQM organisation-wide to improve and manage clinical quality. More broadly, the study aims to identify factors that contribute to innovation implementation in health care for clinical quality improvement, and to generate a model of innovation implementation in health care for clinical quality improvement. Method: This thesis takes a case study approach using multiple research methods. The main methods used comprise interviews with key personnel, assessment of organisational documents and a survey of clinicians' and managers' attitudes and beliefs. Findings: The main finding of the research is that innovation implementation at IHC was a journey, not a destination. Embedded in the journey were five periods and many actions and interactions, grouped into eleven elements. The five periods were: exposing to an innovative idea, embracing the idea, extending knowledge and experience on the idea, emerging of strategies to implement the idea organisation-wide, and enacting and adapting the strategies. The eleven elements were: gestation, shocks, plan, proliferation, fluid participation, setbacks, criteria shift, top executive involvement, relationships and infrastructure building, and adoption. To implement TQM organization-wide, integrated structures and systems were being instituted. The study found that resistance to change came from not only some physicians but also hospital administrators. The study also found that supportive environments played a critical role in the journey. While the TQM implementation at IHC resulted in some cost savings and some behavioural changes including clinical practice change, cultural change at the level of values and beliefs had yet to occur. Conclusion: A process-oriented integrative model of clinical service management is proposed. The elements of an innovation, the temporal change processes, lead to formation and changes of the ongoing organisational processes, which in turn evaluate and improve the important clinical processes. These processes integrate TQM with other quality improvement approaches; also ensure that quality is part of the dialogue between key stakeholders who are responsible for managing and improving clinical quality and costs. These processes also are capable of dealing with dilemmas faced in health care and the constantly created managerial ideas and clinical knowledge. Key Words: Innovation, Clinical Outcomes, Knowledge, Quality and Costs, TQM Management
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Gardner, John. "A sociology of medical innovation : deep brain stimulation and the treatment of children with dystonia." Thesis, Brunel University, 2014. http://bura.brunel.ac.uk/handle/2438/8714.
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This project explores the dynamics of medical innovation using the development of deep brain stimulation therapy in paediatric neurology as a case study. Ethnographic research was conducted with a multidisciplinary clinical team developing a novel clinical service that uses deep brain stimulation (DBS) to treat children and young people with movement disorders. Interviews and observations were carried out to identify key challenges encountered by team members, and to explore the way in which team members attempt to manage these challenges in day-to-day clinical practice. Four key challenges were identified: coordinating multidisciplinary teamwork, identifying suitable candidates for deep brain stimulation; managing the expectations of patients and families; and measuring clinical outcomes. By exploring the strategies used by team members to overcome these challenges, this thesis develops the Complex Model of Medical Innovation which challenges prevalent, linear ‘bench-to-bedside’ understandings of innovation. While scientific ‘discovery’ is one source of medical innovation, new therapies in medicine also emerge from technology transfer (the transfer of technology from one sector into another) and clinicians’ learning-in-practice (the ability of clinician to learn ‘on the spot’). Importantly, this thesis demonstrates that technology transfer, learning-in-practice, and medical innovation in general are shaped by various socio-political trends. The activities of the multidisciplinary team and their novel DBS service, for example, have been shaped by the evidence based medicine movement, commercial interests, and a movement that promotes multidisciplinary approaches to paediatric service provision. A consequence of these influences is that the team subjects their patients to a broad clinical gaze. Adopting the Complex Model of Medical Innovation has important consequences: First, it draws attention to the innovative activities of clinicians, activities that may be worth disseminating in other contexts. Second, it highlights the role of existing social and material factors in shaping the development of new clinical services. The social impact of new technologies will be influenced by these contextual factors and cannot be attributed to the technology alone.
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Dennis, Matthew. "The role of community-led innovation in the adaptive capacity of ecosystem services in an urban social-ecological system." Thesis, University of Salford, 2015. http://usir.salford.ac.uk/35449/.
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Urban areas are hubs of creativity and innovation providing fertile ground for novel responses to modern environmental challenges. One such response is the community-led management of urban green spaces as a form of organised social-ecological innovation (OSEI). Previous studies have attempted to conceptualise the ecological, social and political potential of such informal approaches to urban green space management. However, little work has been carried out into their efficacy in the landscape, either by describing the social-ecological conditions influencing their occurrence or by quantifying the actual benefits in terms of ecosystem service provision. This research explores the emergence and impact of OSEI in a continuous urban landscape comprising the metropolitan areas of Manchester, Salford and Trafford (UK). The social-ecological context and content of OSEI were investigated using a cross-scale approach. At the landscape scale a snowball-sampling method mapped the occurrence of OSEIs using GIS and remote sensing technology. At the micro-scale, a case study quantified relative levels of provision across four key ecosystem services. The analysis presented OSEI as an adaptive response to environmental stressors, clustered around “hubs” of social-ecological innovation in the urban landscape. The distribution of OSEIs was influenced by historical context, degree of urbanisation and dependent on levels of, and dynamics between, social and ecological deprivation. Urban agriculture was instrumental as a catalyst for the emergence of OSEI and the associated production of a range of ecosystem services. Site productivity was also influenced by spatial and design considerations. This thesis has detailed the character of OSEI as a coherent phenomenon in the urban landscape which exhibits valuable response diversity according to social-ecological conditions. This, together with an evaluation of factors influencing ecosystem service provision at the local scale, has informed the validity of OSEI as an element of adaptive capacity which contributes to resilience in urban social-ecological systems.
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Vianna, Rodrigo de Souza. "Processo decisório e inovação em serviços: um estudo a partir da trajetória de uma instituição hospitalar." Universidade do Vale do Rio dos Sinos, 2015. http://www.repositorio.jesuita.org.br/handle/UNISINOS/4955.
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UNISINOS - Universidade do Vale do Rio dos Sinos
A adequada articulação entre processo decisório e inovação em serviços pode levar ao sucesso ou fracasso de uma empresa ou instituição. A inovação em serviços é também o resultado de um processo decisório, e este deve ser bem gerenciado, de forma a abarcar os possíveis desdobramentos deste processo, principalmente para evitar eventuais vieses. A reflexão sobre processo decisório e inovação em serviços no ambiente hospitalar também se justifica pela atualidade do tema. A administração hospitalar é resultado de um sistema que se expandiu, e o hospital é visto como uma empresa moderna. A vantagem competitiva em saúde pode ser obtida através de estratégias de diferenciação ligadas a muitos fatores geradores de custos (estrutura hospitalar e operacional, cultura da organização, entre outras), que precisam ser administrados (PORTER e TEISBERG, 2007; KLOCK, 2009; NEVES, 2009). O estudo buscou demonstrar como ocorre o processo decisório para inovação em serviços em uma instituição hospitalar que, recentemente, implementou novos serviços e em breve ampliará toda a sua estrutura física (inclusive com novas tecnologias e serviços). O estudo também percorreu uma trajetória de forma a verificar se os novos serviços podem ter auxiliado nos resultados financeiros da instituição. No desenvolvimento do trabalho, foram realizadas pesquisas em doutrinas, sites, artigos, bem como coleta de dados através de documentação fornecida pela instituição e entrevistas com alguns tomadores de decisão da instituição. O estudo teve como objetivo geral identificar o funcionamento do processo decisório na inovação em serviços em um ambiente hospitalar, e verificar de que forma tais inovações podem ter impactado os resultados financeiros da instituição. Já os objetivos específicos deste trabalho foram identificar como funciona o processo decisório da instituição hospitalar em estudo, quais as inovações em serviços foram implementadas recentemente, bem como quais foram os seus objetivos e resultados financeiros alcançados. Analisando os dados coletados, buscou-se entender se as decisões tomadas, sobre os novos serviços, realmente beneficiaram o desempenho da instituição. Os principais resultados sugerem que existe relação entre os investimentos em novos serviços e os resultados da instituição. Assim, a decisão pela ampliação da estrutura física, que também será acompanhada de novos investimento em serviços, pode ter sido uma acertada decisão.
Proper coordination between decision-making and innovation in services can lead to success or failure of a company or institution. Innovation in services is also a result of a decision-making process, and this must be well managed in order to cover the possible consequences of this process, mainly to avoid any bias. The consideration of decision-making and innovation in services in hospitals is also justified because this theme is current. The hospital administration is a result of the system that has expanded, and the hospital is seen as a modern company. Competitive advantage in health can be achieved through differentiation strategies related to many factors causing costs (hospital and operational structure, culture of the organization, etc.) that need to be administered (Porter and Teisberg, 2007; Klock, 2009; Neves, 2009). The study sought to demonstrate how is the decision-making process for innovation in services in a hospital,whichrecently implemented new services and soon it will expand its entire physical structure (including new technologies and services). The study also covered a trajectory in order to demonstrate if the new services may have aided the recent results of the institution. In developing this work, surveys were conducted in doctrines, websites, articles, and data collection through documentation provided by the institution and interviews with some decision makers of the institution. As a general aim, the study wanted to identify the functioning of the decision-making process on innovation in services in a hospital setting, and check how these innovations impact the results of the institution. As for the specific objectives of this study they were to identify how the decision-making process works, which innovations in services have been implemented recently, and what were your goals, beyond of understanding the relationship between decision-making and innovation in services in the context of the study. Analyzing the data collected, we sought to understand whether the decisions taken on the new services actually benefited the performance of the institution. The main results suggest that there is a relationship, although not significant, between investments in new services and the results of the institution. Thus, the expansion of physical infrastructure, which will also be accompanied by new investments in technologies and services, suggests a positive conclusion as to the decision made.
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Telemo, Nilsson Sara, and Laurinda Rexha. "When the physical patient becomes digital : A study of the innovation “digital health care center” on the Swedish market." Thesis, Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-32145.
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Object of study: The innovation “Digital health care center” from a multi-level stakeholder’s perspective. Problem: A new technology era has opened up for new kind of innovations. Digital health care centers are a service that recently has been introduced on the Swedish market, which needs further investigation. To be able to better understand, explain and predict future behavior of an innovation the innovation could be theoretical conceptualized and classified. In the specific area of health care, new innovation should preferable be investigated in from a multilevel perspective, including different stakeholders opinions. One if the stakeholders are the customers. If new innovative products and services want to be successful, it required consumers to adopt the product or service, but relatively few studies have focused on the adoption of technology services among customers. Purpose: The purpose of this thesis is to gain a better understanding of the innovation “digital health care center” in Sweden. Research question: How can the innovation “digital health care center” be described through a stakeholder perspective? Method: The empirical data were collected through qualitative semi-structured interviews and a structured quantitative questionnaire. Conclusions: The innovation digital health care center can from a multi-level perspective be described as an innovation that contributes and have an impact on the market and the healthcare industry in many ways. The innovation could be described as a complement to traditional health care. The innovation has influences from different theoretical classes of innovation which means that the innovation cannot be categorized in a specific class. The innovation can be considered successful because it facilitates for the patient.. According to the stakeholder group potential patients, a majority of the respondents thinks that increased availability and time-efficiency would be facilitating factors and reasons for using the service. The innovation is described by the various stakeholders as contributing to a better society. The care becomes more productive, cost effective, more available, and in the broader perspective, the innovation contributes to increased digitalization of the healthcare sector as a whole. There are many new possible fields of application which in the healthcare industry which could develop the innovation further. Strengths and opportunities with the innovation can be considering outweighing weaknesses with the innovation and potential threats of the innovation.
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Eriksson, Per Gustav. "Analysis of Physiotherapists Perceptions for Improvement of Digital Innovation." Thesis, KTH, Medicinteknik och hälsosystem, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-279129.
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With the current challenges for the healthcare such as increased demand for care, financial and resource constraints along with rapid changes and complexity there is high believe in digital innovation and digitalisation to efficacy resources and aid in delivering a safer, more accessible and patient centred valuable care. There is a digitalisation that is ongoing, being used and implemented over several different areas of healthcare. Since healthcare can be seen as a complex adaptive system, there is a need to understand several agents. The aim is to gather more knowledge about perceptions within the physiotherapy staff and give recommendations and directions for improvements regarding digital innovation. Opinions about digital innovation have been gathered with open interviews and a semisystematic literature review with focus on physiotherapy. Too find subjective data the mixed method Q methodology was applied. The open interviews resulted in eight categories: digital innovation, digital innovation being used, digital innovation not used, management, obstacles, education, wishful thinking, applications and systems and associated opinions. The semi-systematic literature review showed on a rapid scientifically development, 25 articles was found and thematically analysed. 140 cited viewpoints and facts was merged with the results from the open interviews. Ten physiotherapists performed the q-sort consisting of 25 statements. Three factors were found. Interpreted as digital innovation optimism & patient oriented, digital innovation scepticism & management oriented and digital innovation sceptical optimism. Video-call technique is strongly encouraged by factor one contrary to factor two. Integrity is the major conflicting viewpoint between the factors. The result shows that gender can affect if a physiotherapist is either optimistic or sceptical to digital innovation. Using existing models such as UTAUT could improve acceptance about digital innovation. Education is perceived as important among all factors. Nine participants responded on baseline questions showing low knowledge of the term mHealth and little communication with IT departments.
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Edvardsson, Kristina. "Health promotion in pregnancy and early parenthood : the challenge of innovation, implementation and change within the Salut Programme." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-70172.
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Background: In 2005, the Västerbotten County Council launched a child health promotion programme, “the Salut Programme”, in response to an alarming prevalence of overweight and obesity, and trends of increased dental caries, among young county citizens. The programme, initially developed in four pilot areas, is built on multidisciplinary and cross-sectoral collaboration and aims to support and strengthen health promotion activities in health care, social services and school settings. It targets children and adolescents (0-18 years of age) and their parents, and starts during pregnancy. This thesis focuses on interventions provided by antenatal care, child health care, dental services, and open pre-schools, directed to expectant parents and families with children aged 0-1 ½ years. Within the programme context, the aim was to explore socio-demographic patterns of overweight and obesity in expectant parents (Paper I), firsttime parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood (Paper II), professionals’ experiences of factors influencing programme implementation and sustainability (Paper III and IV), and early programme outcomes on professionals’ health promotion practices and collaboration following countywide dissemination and implementation (Paper IV). Methods and results: A population based cross-sectional study among expectant parents showed overweight and obesity in 29% of women (pre-pregnancy) and in 53% of men (n=4,352♀, 3,949♂). The likelihood for obesity was higher in expectant parents with lower levels of education, among those unemployed or on sick leave, and those living in rural areas. In 62% of couples, at least one of the partners was overweight or obese; a positive partner correlation was also found for BMI (I). An interview study with 24 first-time parents (n=12♀, 12♂) revealed that they primarily undertook lifestyle changes to secure the health of the fetus in pregnancy, and to provide a healthy environment in childhood. Parents described themselves as highly receptive to information about how their lifestyle could influence fetal health, and they frequently discussed pregnancy risks related to tobacco and alcohol, as well as toxins and infectious agents in foods. However, parents did not seem inclined to make lifestyle changes primarily to promote their own health. The antenatal and child health care services were perceived as being mainly directed towards women, and parents described a lack of a holistic view of the family which included experiences of fathers being treated as less important (II). An interview study undertaken with professionals (n=23) in the Salut Programme pilot areas indicated programme sustainability at most sites, two years after implementation, although less adherence was described within child health care. Factors influencing programme sustainability, as described by professionals, were identified at multiple organisational levels (III). A before-and-after survey among professionals (n=144) measured outcomes of the county-wide implementation of the Salut Programme in 13 out of 15 county municipalities. Results showed significant improvements in professionals’ health promotion practices and collaboration across sectors. A number of important implementation facilitators and barriers, acting at different organizational levels, were also identified via a survey comprised of open-ended questions (IV). Conclusion: The Salut Programme, developed with high involvement of professionals, and strongly integrated in existing organisational structures and practices, shows potential for improving health promotion practices and cross-sectoral collaboration. The findings can inform further development of the Salut Programme.as well as new health promotion initiatives, and inform policy practice and future research. These aspects include approaches in health promotion and prevention, father involvement during pregnancy and early parenthood, and factors influencing implementation and sustainability of cross-sectoral health promotion programmes.Bakgrund: År 2005 lanserade Västerbottens läns landsting en hälsofrämjande satsning “Salut” som svar på en oroande förekomst av övervikt och fetma samt trender till ökad förekomst av karies hos barn i länet. Satsningen, som initialt utvecklades i fyra pilotområden, bygger på tvärprofessionellt och verksamhetsövergripande samarbete och syftar till att stödja och stärka hälsofrämjande insatser inom landstinget och länets kommuner. Satsningen riktar sig till barn och unga (0-18 år) och deras föräldrar, med start under graviditeten. Denna avhandling fokuserar på insatser som erbjuds via mödrahälsovård, barnhälsovård, tandvård och öppen förskola riktade till blivande föräldrar och familjer med barn i åldern 0-1 ½ år. Med utgångspunkt från Salut-satsningen syftar avhandlingen till att undersöka socio-demografiska mönster av övervikt och fetma hos blivande föräldrar (I), förstagångsföräldrars upplevelser av hälsofrämjande insatser och förändrade levnadsvanor under graviditet och tidigt föräldraskap (II), personalens upplevelser av underlättande och hindrande faktorer för satsningens införande och uthållighet (III, IV), samt förändringar i arbetssätt och samarbete mellan verksamheterna efter den länstäckande spridningen av satsningen (IV). Metod och resultat: En populationsbaserad tvärsnittsstudie bland blivande föräldrar visade på övervikt och fetma hos 29% av kvinnorna (vikt före graviditet) och hos 53% av männen (n=4352♀, 3949♂). Lägre utbildningsnivå, arbetslöshet och sjukskrivning samt att bo utanför städerna visade sig öka sannolikheten för fetma. Hos en övervägande del av paren (62%) fanns minst en partner med övervikt eller fetma och samband kunde även påvisas mellan kvinnans och mannens BMI (I). En intervjustudie med 24 förstagångsföräldrar (n=12♀, 12♂) visade att föräldrarna främst förändrade sina levnadsvanor för att säkra hälsan hos fostret under graviditeten och för att skapa en hälsosam miljö för barnet under uppväxten. Föräldrarna beskrev sig själva som mycket mottagliga för information om hur deras levnadsvanor kunde påverka fostrets hälsa och de diskuterade ofta graviditetsrisker i relation till tobak och alkohol samt gifter och smittoämnen i livsmedel. Föräldrarna var dock mindre angelägna att förändra sina levnadsvanor med tanke på sin egen hälsa. De upplevde att mödrahälsovårdens och barnhälsovårdens insatser i huvudsak riktades till kvinnor och beskrev en avsaknad av helhetssyn på familjen, vilket även avspeglades i upplevelser av att papporna behandlades som mindre viktiga (II). En intervjustudie med personal (n=23) inom pilotområdena, två år efter utveckling och införandet av Saluts insatser, indikerade god uthållighet av satsningen, även om en lägre följsamhet till insatserna beskrevs inom barnhälsovården. Faktorer som av personalen beskrevs påverka uthålligheten identifierades på flera organisatoriska nivåer (III). En före- och efterstudie bland personal (n=144) mätte effekter av den länstäckande spridningen av satsningen i 13 av länets 15 kommuner. Resultaten visade på flera signifikanta förbättringar av de hälsofrämjande arbetssätten och ett ökat samarbete mellan verksamheterna. En enkät med öppna frågor riktad till personalen belyste också faktorer på flera organisationsnivåer som ansågs underlätta respektive hindra införandeprocessen (IV). Slutsats: Salut-satsningen, som är utvecklad i nära samarbete med verksamheternas personal och väl integrerad i redan existerande organisatoriska strukturer och arbetssätt, visar på potential att förbättra hälsofrämjande arbetssätt och samarbete mellan verksamheter. Aspekter som beskrivits och diskuterats kan vägleda satsningens fortsatta utveckling såväl som framtida nya initiativ. Resultaten och slutsatserna kan även användas i syfte att påverka policy, praxis och framtida forskning. Detta avser framförallt hälsofrämjande och sjukdomsförebyggande metoder, pappans roll under graviditet och tidigt föräldraskap samt kunskaper om faktorer som kan ha betydelse för genomförande och uthållighet av verksamhetsövergripande hälsofrämjande insatser.
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Lucas, D. Pulane. "Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/2996.
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Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs.
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Thyagaraj, Arjun, and Krishnakumar Narayanan. "Internet of Things (IoT) adoption in Indian Healthcare Industry-A case study from a hospital." Thesis, Högskolan i Halmstad, Akademin för företagande, innovation och hållbarhet, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-45313.
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Purpose: Internet of Things (IoT) is an emerging technology and is a technological paradigm that is revolutionizing the healthcare industry all over the world. The purpose of our thesis is to investigate the phenomenon of IoT adoption in the healthcare industry in the context of a developing country to find out the barriers and how the industry is trying to overcome them. As the second highest population with a landmark of topping the table of developing country list, India has significant potential to bring interest in the IoT adoption in healthcare. Our unit of analysis is a hospital in India. Method: To reach our research, we have chosen a qualitative research approach and systematic combining method as our research strategy, which will facilitate us to narrow down the findings of the phenomenon by using a back and forth process. Semi-structured interviews have been conducted with participants of the case hospital as part of the data collection process. Finding and Analysis: The first part of the empirical finding is analyzed by the thematic analysis tool, which we have used for the data analysis. This enabled us to interpret the themes in our own way going back to data collected and previous literature references. The study helped us identify some of the main factors affecting IoT adoption in the hospital, categorized under three different sections: technological, organizational, and environmental. The findings indicate that IoT adoption barriers in hospital are categorized as per our tentative framework with theoretical frame reference in the literature review part. Adoption challenges were found mainly centred on technological acceptance, complexity, organizational behaviour, lack of expertise and infrastructure, lack of stringent regulations and standard and finally, the security and privacy concerns. They have initiated a well organizational structure with experts, providing rigorous training for key staff and visionary leadership to facilitate the adoption process.
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Robertson, Karen E. "The diffusion of joint mother and baby psychiatric hospital admissions in the UK : an historical analysis." Thesis, University of Stirling, 2012. http://hdl.handle.net/1893/11295.
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Background: A key innovation in the provision of inpatient services to facilitate the care and treatment of women with severe postnatal mental illness was the introduction of joint mother and baby psychiatric hospitalisations, where both the mother and baby are admitted to hospital together. This study examined the history of the practice of joint mother and baby admissions across the UK and critically explored the processes relevant to the diffusion of joint admissions and patterns of service development to identify the possible and probable causes for significant differences in service provision across the United Kingdom (UK). Aims: The study examined the documented history of the development of practice of joint mother and baby psychiatric hospital admissions across the UK and in doing so, a) Identified the pattern of service and practice development and the likely reasons for the pattern of the chronology. b) Identified the processes involved in the diffusion of joint mother and baby admissions in the UK, and explored why the practice was sustained (or not). c) Contributed new information to the continued development of innovation diffusion theory and research, and its application to health care service and practice development. Methods: A historical method was used in the study and was reported through the use of historical narrative and analysis. Data was collated from primary and secondary sources of documented evidence which was used to inform the history of joint mother and baby admissions across the UK. Data was analysed using the theoretical framework of diffusion of innovation (Rogers, 2003). Findings: Two versions of the same innovation were identified: joint admissions to side rooms of general adult psychiatric wards or annexed areas of the wards and joint admissions to specialist mother and baby units. Neither version of the practice followed the normal S-curve pattern of adoption in terms of frequency and rate of adoption. After a period of approximately 63 years there are 24 facilities for the provision of joint admissions in the NHS in the UK. The main influencers to the adoption of the practice was perception of risk, social networks internal and external to the NHS, the presence of clinical and political champions to drive the adoption and implementation of the innovation and policy entrepreneurship by clinicians working in the clinical field of perinatal mental health. The development of specific policy, guidelines and in Scotland, legislation, has resulted in a move during the last decade from joint admissions being diffused naturally to side room admissions being actively withdrawn and specialist psychiatric mother and baby units actively being disseminated. There is strong evidence that the diffusion process for specialist mother and baby units is still in motion at the time of reporting. Conclusion: Two competing versions of the same innovation had unusual patterns of diffusion. The influencers identified as relevant to the diffusion patterns of each version of the innovation were essentially the same influencers but they were used in different ways to affect change: rejection of one version of the innovation in favour of adoption of the other. The main influencers on the diffusion of joint admissions changed over the time line of the adoption pattern. Barriers to diffusion included the absence of evidence of effectiveness, the absence of economic evaluation, the position in service divisions of perinatal mental health as a field of practice and the absence of succession planning across professional groups. Recommendations are made for future research.
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Wang, Tianyi. "International students’ stress : Innovation for health-care service." Thesis, Linnéuniversitetet, Institutionen för design (DE), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-76296.
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With the trend of increasing international academic exchange, the number of international students in Sweden continues to expand over years. The stress faced by international students has attracted more and more attention from university organizations and the society. This project takes the current mental health-care service for international students at Linnaeus University as the research object. Based on the participatory design and service design theory, challenges faced by the international student health-care service system and improvement opportunities were investigated through a stakeholder map, semi-structured interviews, observations, questionnaires and co-creation workshops among other methods. By introducing participatory design into the development process, an improved mental health-care service system with integrated online and offline information is presented as an example for universities’ organizations for improving the mental health-care service for international students.
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Savory, Clive. "User-led Innovation in the UK National Health Service." Thesis, Open University, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.518175.
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Marciano, Marcelo Antunes. "Gestão de serviços de saúde análise da qualidade dos sistemas de saúde público e suplementar do estado do Rio Grande do Sul." Universidade do Vale do Rio dos Sinos, 2014. http://www.repositorio.jesuita.org.br/handle/UNISINOS/3968.
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Este trabalho investiga como aumentar a qualidade dos serviços entregues à população pela gestão de operações em serviços de saúde, tanto no sistema público quanto na saúde suplementar, mais especificamente, em operadoras de plano de saúde e em hospitais do estado do Rio Grande do Sul (RS). O objetivo principal do presente trabalho consiste em analisar possibilidades de elevar a qualidade do sistema de saúde público e suplementar do estado do Rio Grande do Sul à luz do sistema dinâmico em que se inserem. Os objetivos específicos são: Mapear o sistema de saúde, por meio do pensamento sistêmico, e propor pontos de alavancagem à qualidade do sistema de saúde pública do RS; e Analisar a aderência aos critérios do Managed Care e de inovações em gestão de saúde, pelos atores “operadora de plano de saúde” e “hospital”. A dissertação é formada por dois artigos, cada um entregando um objetivo específico, e por capítulos adicionais que consolidam a entrega do objetivo geral. Quanto aos procedimentos metodológicos, a pesquisa parte de um paradigma positivista e orienta-se qualitativamente, fazendo uso de entrevistas, análise documental, coleta de dados secundários em bancos de dados de acesso público, análise por julgamento em dinâmica de grupo multidisciplinar e modelagem. Como resultados obteve-se a construção de um mapa que evidencia os atores e as relações desse sistema dinâmico, possibilitando a identificação de possíveis cenários, pontos de alavancagem e a sugestão de estratégias para auxiliar no aumento da qualidade do sistema de saúde pública do RS, bem como a construção de uma ferramenta, no caso, um questionário, por meio do qual foi possível verificar que os atores hospitalares contatados encontram-se mais aderentes do que as operadoras de plano de saúde contatadas com relação às boas práticas de gestão orientadoras do estudo. Argumenta-se que um sistema integrado de gestão, padronizado, empregado de forma sistêmica, com auxílio de estratégia organizacional, de inovações e com foco na cadeia de valor, contempla aspectos assistenciais, econômicos e competitivos, desses atores e, como consequência, pode contribuir para que as operadoras e hospitais possam aumentar a qualidade dos serviços prestados.
This work examines how to improve quality in health services, both in the public system and in supplementary health, more specifically, in health insurance companies and hospitals in the state of Rio Grande do Sul (RS). The main goal of the present work is to improve quality for the public and supplementary health systems in the state of Rio Grande do Sul under the dynamic system they are included into. Specific goals are: Mapping the health system through systemic thinking, proposing points of leverage regarding the quality of the public health system in RS; and analyzing the compliance with the Managed Care criteria and innovation in health management by the players, namely, “health insurance companies” and “hospitals”. The work is composed of two articles, each delivering a specific goal, and by additional chapters that consolidate the delivery of the general goal. As for the methodological procedures, the research develops from a positivist paradigm and it is based on a qualitative perspective, making use of interviews, document analysis, secondary data collection in public-access databases, analysis based on multidisciplinary group dynamics assessment and modeling. As a result, this led to the creation of a map that highlights players and relations of this dynamic system, allowing for the identification of possible scenarios, points of leverage, and the suggestion of strategies to help improve the quality of the public health system in RS, as well as the awareness that contacted hospital players were found to be more compliant than the contacted health insurance companies as far as good management practices that guided this study are concerned. We argue that a integrated and standardized management system, which is systematically used, with the help of organizational strategies, innovation, and a focus on the value chain, takes into account assistance-related, economic, and competitive aspects of these players and, as a consequence, it may contribute to improve quality to services provided.
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Sherry, Julia Caroline. "Perceptions of water services and innovations to improve water services in Tanzania." Thesis, Virginia Tech, 2017. http://hdl.handle.net/10919/78238.
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Lack of access to safe drinking water is a crisis of great proportion. An estimated 1.8 billion people rely on unsafe drinking water. This study focuses on the case of Tanzania, in which an estimated 29 million people, or 44% of the population, lack access to safe drinking water. Furthermore, the Tanzanian Ministry of Water estimates that approximately 38% of all water access points in the country are nonfunctional. As the Government of Tanzania and other actors work to improve water access, they employ innovations to facilitate water service delivery that is both high quality and sustainable over time. These innovations must be field-tested prior to large-scale implementation to ensure they are appropriate and effective in varying contexts. User perceptions of innovations are valuable for gauging the potential benefits and barriers to incorporating new innovations in the water sector. This study investigates the use of solar power and mobile prepayment to improve water services in Tanzania. There are currently no data on user perceptions of these innovations in Tanzania. Thus, this study fills this data gap through the analysis of focus group discussions (n=6) and key informant interviews (n=14) collected during summer 2016 in three urban and three rural communities in Tanzania. Urban sites are located in the city of Dar es Salaam, and rural sites are scattered throughout Tanzania. Using qualitative methods, this study identifies themes related to user perceptions of water services, solar power, and mobile prepayment. While perceptions varied between urban and rural study settings and within study sites, most people perceived major challenges with the current water system. These perceived challenges included the poor reputation of the water service provider, health problems related to water, and the general lack of consistent high-quality water provision. Research participants perceive that mobile prepayment is a modern solution to water service challenges, but perceive that cost, particularly for the poor, may be a barrier. Generally, people in the rural setting perceive that solar power will reduce costs and increase water service reliability, while those in Dar es Salaam were less familiar with the technology. While perceptions indicate that solar and mobile phone innovations have great potential in both urban and rural settings, they also indicate that there exist significant challenges to implementing the innovations. User perceptions ultimately manifest in real behaviors related to water services, and thus must be incorporated before these innovations are scaled-up across Tanzania.Master of Science
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Snyder, Hannah. "Health Care Customer Creativity." Doctoral thesis, Linköpings universitet, Logistik- och kvalitetsutveckling, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-125723.
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Crafting and stimulating service innovation is considered a main research priority and remains a challenge for service providers. One suggested component of stimulating service innovation is customer creativity. Customers who adapt, modify and transform services or products to better suit themselves are increasingly being recognized as a source of competitive value and innovation. It has been proposed that understanding and supporting the customer’s value creating practices is the key to creating and sustaining value over time in health care. Health services directly address a customer’s well-being and have a significant impact on his or her quality of life. In these types of services, the service outcome is highly dependent on the activities of the individual customer. Health care services often require customers to participate extensively, over long periods of time, with limited support and control. Health services also stretch far beyond the particular service setting into the customer’s daily life. While research, policy, and legislation have all emphasized the active role of health care customers, such customers have traditionally had few opportunities to design their health care services. Nevertheless, health care customers solve health-related problems and engage in self-care and medical decision-making on a day-to-day basis, although this creativity is often unknown to the service provider. To understand how health care customers can enable service innovation, this thesis seeks to conceptualize and investigate the concept of customer creativity in health care. The thesis focuses on customer creativity, not only as an outcome, but also as a dynamic and contextualized process that can be enhanced. The thesis combines insights from health care research with service and innovation research to provide build a framework for health care customer creativity. Building on five papers, the research develops an understanding for health care customer creativity. The individual papers are based on systematic literature reviews as well as empirical data in the form of customers’ ideas for service innovation collected through diaries. The results of the thesis suggest that despite the negative nature of the service, health care customers are creative. Given the opportunity, health care customers can provide creative ideas and solutions on a multitude of aspects, both within and outside the health care setting. This provides the potential to view the health care experience through the customers’ eyes and take part in their creativity in spheres where the service providers have not traditionally had any access. This thesis contributes to the literature by providing a framework for health care customer creativity that recognizes the concept as a complex interplay of factors operating at the individual, contextual, and situational levels. The proposed framework specifies the health care specific factors upon which customer creativity depends, with the intention of positing potential research directions and developing an enriched theory of health care customer creativity.
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Grego-Nagel, Anne C. "An exploratory study of the adoption of mobile telecommunications service in order to improve mobile health service development." Diss., Kansas State University, 2016. http://hdl.handle.net/2097/34554.
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Doctor of PhilosophyDepartment of Industrial & Manufacturing Systems Engineering
Malgorzata J. Rys
This dissertation is the result of exploring the phenomenon of the adoption of a service innovation, in particular mobile telecommunications service, with the goal of informing the design of mobile health services. A grounded research study led to the finding that older adults may not abandon a legacy service, such as landline telecommunications service, when they adopted mobile telecommunications service. To further understand the results of the first study, a multidisciplinary literature review was undertaken and resulted in a typology of the factors of individual-level innovation adoption that can be applied by human factors professionals in the field. The three categories of factors included macro environmental, innovation-specific, and human factors. A research analysis of a study done by a county health department provided insights into what older adults contributed to the service production process in healthcare services including which common proxies do not accurately reflect the situations of older adults. A three-state process model of individual-level innovation adoption, which incorporated the role of a legacy system, was developed using the adoption patterns of mobile telecommunications services. In this model, individuals move from a state of using a legacy system to adopting a innovative system while still using the legacy system. After a period of time, the individual moves from the state of dual use to fully abandoning the legacy system and using only the innovative system. A compartmental mathematical model is developed to allow the model to be simulated and future service demand needs can be better predicted. Two decision-making processes were identified to be employed by individuals in the abandonment of a landline telecommunications services. Finally, recommendations for the design of mobile health services are provided.
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Parry-Jones, Beth. "Innovative practice and occupational stress in care management." Thesis, Bangor University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275178.
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Loh, Poh Kooi. "Innovations in health for older people in Western Australia." University of Western Australia. School of Medicine and Pharmacology, 2009. http://theses.library.uwa.edu.au/adt-WU2010.0051.
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Australia and many other developed communities are ageing rapidly, placing a strain on the delivery of health services. This thesis examines the use of innovative health services management coupled with information and communication technology (ICT) to more efficiently deliver services to disabled older people in the hospital, community and residential care. The hypothesis explored is that ICT can provide clinical services to older people in poorly serviced communities and groups, thus extending the influence and capabilities of specialist health care professionals. The relevance of these studies is predominantly for those people who live outside the metropolitan regions, particularly in remote and rural communities, and also for those frail older people, who because of disability, are unable to travel to specialist health services. There are a series of studies presented in this thesis which have all been published. They have demonstrated that in a community and rural setting, ICT use in the assessment and management of geriatric syndromes such as dementia is valid and practical. This included the validation of commonly used assessment tools via Telehealth. A Telehealth protocol for assessment of Alzheimer's Dementia (AD) was developed and published. The use of ICT to link health services clinical and administrative data for determining stroke outcomes and disability has been evaluated and a resource utilization prediction model developed. Finally, in residential care a survey and a qualitative study of poor uptake of ICT services in hostels and nursing homes revealed insights into ICT perception by the older people in care facilities and their professional staff. The implications and future development of these studies have been discussed, especially barriers to increased uptake of ICT, cost comparisons and the potential of future technologies such as video conferencing mobile phones.
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Kortstee, Michiel Jeroen Herman Willem. "Making sense of management innovation in health care." reponame:Repositório Institucional do FGV, 2018. http://hdl.handle.net/10438/25694.
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This thesis aims at exploring stakeholders’ perceptions of management innovation in health care. Rising health care costs due to technological innovation and demographic developments and advanced insights on how health and care could be organized drive the search for new organizational models and technologies that may contribute to better health outcomes for lower costs. Multiple stakeholders across the health care continuum need to collaborate in integrated care networks with multiple interdependent components. The study is based on qualitative exploratory research and consists of a literature review and a case-study at a management innovation in an university medical center. This study explores the vision and perceptions of stakeholders of innovation in healthcare, the innovation process through which management innovations evolve, underlying change and steering mechanisms, critical success factors and results. Management innovations and their implementation are considered complex. It is observed that due to different backgrounds and professional logics, stakeholders have partial and different understandings of integrated care concepts. Awareness of the different understandings explains the importance of an implementation approach of integrated care concepts where these perceptions converge. Sense making, the attribution of meaning to perceptions is essential here. Change does not happen in a vacuum, but emerges in interaction with other actors in the organization and its local context. It is observed in the literature and case-study that sense making processes are at work in the innovation process. Management innovation is merely a spontaneous, unplanned change process that starts with an intrinsic drive and emerges from how people frame what they see, relate it to their values and act upon it in interaction with others. It is a human, subjective, interactive, emergent selforganizing process of sensing and sense making that – if aligned with vision, values and intentions of people – can bring together different stakeholders in joint concepts of integrated care. Leading management innovation processes becomes a matter of guiding and creating room for self-organizing processes in organizations. Examples of management innovation from across the world demonstrate that management innovation can significantly contribute to better health outcomes for lower costs. The willingness, necessity and ability to change determine the pace. Exploring further and investing in the potential of management innovation may be a wise choice to make health systems more sustainable.
Esta tese tem como objetivo explorar as percepções dos stakeholders sobre inovação em gestão na área da saúde. Aumento dos custos de cuidados de saúde devido à inovação tecnológica e mudanças demográficas e insights avançados sobre como saúde e cuidados poderiam ser organizados impulsionam a busca de novos modelos organizacionais e tecnologias que podem contribuir para melhores resultados de saúde com menores custos. Múltiplos stakeholders em toda a cadeia de cuidados de saúde precisam colaborar em redes de atenção integradas com múltiplos componentes interdependentes. O estudo é baseado em pesquisa qualitativa exploratória e consiste em uma revisão da literatura e um estudo de caso de inovação em gestão em um centro médico universitário. A tese explora a visão e as percepções dos stakeholders sobre inovação nos cuidados de saúde, o processo de inovação através do qual as inovações de gestão evoluem, mecanismos subjacentes de mudança e direção, fatores críticos de sucesso e resultados. As inovações de gestão e sua implementação são consideradas complexas. Observa-se que, devido às diferentes origens e lógicas profissionais, os stakeholders possuem entendimentos parciais e diferentes dos conceitos de cuidado integrado. A conscientização dos diferentes entendimentos explica a importância de uma abordagem de implementação de conceitos de cuidados integrados nos quais essas percepções convergem. Sense-making, a atribuição de significado às percepções, é essencial aqui. A mudança não acontece no vácuo, mas surge em interação com outros atores da organização e seu contexto local. Observa-se na literatura e estudo de caso que processos de sense-making estão presentes no processo de inovação. A inovação gerencial frequentemente é um processo de mudança espontâneo, não planejado, que começa com uma motivação intrínseca e emerge de como as pessoas enquadram o que vêem, relacionam-se com seus valores e agem de acordo com eles em interação com os outros. É um processo humano, subjetivo, interativo, emergente de auto-organização de sensing e sense-making, que, se alinhado com a visão, os valores e as intenções das pessoas, pode reunir diferentes stakeholders em um único conceito de cuidado integrado. Os principais processos de inovação gerencial tornam-se uma questão de orientar e criar espaço para processos de autoorganização. Exemplos de varias partes do mundo demonstram que a inovação gerencial pode contribuir significativamente para melhores resultados de saúde com custos mais baixos. A vontade, necessidade e capacidade de mudar determinam o ritmo. Explorar mais e investir no potencial da inovação gerencial pode ser uma escolha sábia para tornar os sistemas de saúde mais sustentáveis.
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Quaggio, Frederico Medeiros. "Contribuições para o modelo de desenvolvimento de novos serviços: um estudo de caso em serviços de atenção básica à saúde." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/3/3136/tde-23042009-175005/.
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O Desenvolvimento de Novos Serviços (DNS) tem recebido atenção crescente, tanto por parte de gestores de operações de serviço, quanto por parte dos acadêmicos do setor. Esta dissertação parte do pressuposto que os modelos DNS, desenvolvidos a partir de experiências com serviços em massa e loja de serviços, não abordam na sua totalidade os desafios de operações de serviços marcadas por maior dinamismo, especialmente serviços profissionais. Partindo de um referencial teórico montado com o objetivo de identificar quais são as características dos serviços profissionais que potencialmente influenciam positivamente ou negativamente o desenvolvimento de novos serviços, esta dissertação utiliza uma metodologia de pesquisa baseada em estudos de caso múltiplo para avaliar se o panorama teórico construído anteriormente é condizente com dois casos de inovação em serviço profissional público. A partir destas conclusões, destacamos algumas implicações práticas que pudemos observar e analisamos de que forma o modelo DNS proposto por Edvardsson et al (2000) está preparado ou não para lidar com estas questões.New Service Development (NSD) has received increasing attention from either service managers or service marketing researchers. This dissertation firstly discuss that NSD models developed from mass services or services shop experiences, do not totally comprehend more dynamic services challenges, specially professional services. Following a literature review that aims to identify which professional services characteristics may influence positively or negatively the new service development process, this dissertation uses a multiple case study research to evaluate if the theoretical framework built before is related to two public professional services innovations case. From theses conclusions, we point out some practical implications that we could observe and after that we analyze if the NDS model proposed by Edvardsson et al (2000) is or is not prepared to deal with theses questions.
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Niles, B., V. Gifford, Jodi Polaha, I. Rivkin, and C. Koverola. "Innovative Competency Training in Ethical Decision Making for Providers Delivering Telebehavioral Health Services." Digital Commons @ East Tennessee State University, 2008. https://dc.etsu.edu/etsu-works/6612.
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Bose, Ruchira. "Innovations in care for children with mental handicaps : an evaluation of the Canterbury and Thanet family link scheme." Thesis, University of Kent, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305077.
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Engström, Jon. "Patient involvement and service innovation in healthcare." Doctoral thesis, Linköpings universitet, Kvalitetsteknik, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-106661.
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This thesis adds to a stream of research suggesting that healthcare can be more patient centered and efficient by redefining the role of the patient from a passive receiver to a more active and collaborative participant. This may relate to healthcare provision (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) and innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Through research initiative containing four healthcare units and 68 patients, the present thesis combines healthcare research (e.g., Anderson and Funnell, 2005; Nelson et al., 2002) with service research (e.g., Grönroos, 2006; Vargo and Lusch, 2008, 2004) to explore three aspects of patient involvement and service innovation. Firstly, the concept of patient involvement itself is investigated through an extensive literature review of empirical research on patient involvement. A model describing the antecedents, forms and consequences of patient involvement is proposed. What value is, and how patients can co-create value is discussed from the perspectives of healthcare research and service management thought. Secondly, the thesis proposes a diary-based methodology for involving patients in service innovation. My colleagues and I developed the methodology in collaboration with the participating care providers and applied it in practice. We used the experiences we gained from the project and the contributions from the patients to examine the opportunities for user involvement in service innovation. The participants contributed with ideas and insights stemming from their experiences in their contact with healthcare and other resources. We suggest the following three ways of learning from the collected data: As ideas for improvements; through summary reports to illustrate other quantitative data; and as narratives to promote change. Thirdly, the thesis explores patients’ motivations to participate in service innovation, a hitherto unexplored field. Through an analysis of patients’ contributions and interviews with participants we found that there are a number of factors that motivate patients to participate and that participation is perceived as a social- and meaningladen event. Patients derive psychological well-being and support from participation, but disease was sometimes a barrier to participation. This thesis elaborates on how the most motivated users can be involved in service innovation, applying thinking from the lead-user methodology to a healthcare setting. Overall, the thesis explores patient involvement from new perspectives and, by doing so, adds to our collective efforts to improve healthcare.Denna avhandling syftar till en mer patientcentrerad och effektiv sjukvård. Den bidrar till en strömning inom forskningen som menar att sjukvården kan förbättras genom en omdefiniering av patientrollen – från en roll som passiv mottagare till aktiv, samskapande aktör. Patienten kan ses som en resurs både i utförande av vården (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) och inom utveckling och innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Avhandlingen kombinerar sjukvårdsforskning (Anderson and Funnell, 2005; Nelson et al., 2002) med tjänsteforskning (Grönroos, 2006; Vargo and Lusch, 2008, 2004) i en forskningsansats som innefattar fyra vårdenheter och 68 patienter. Den utforskar tre aspekter av patientinvolvering och tjänsteinnovation. För det första undersöks konceptet patientinvolvering genom en omfattande litteraturöversikt av den empiriska forskningen på området. Översikten leder till en konceptuell modell för att beskriva patientinvolvering: vad dess förutsättningar är, vilka former av patientinvolvering som finns och vad patientinvolvering leder till. Avhandlingen diskuterar även begreppet värde och hur patienter kan samskapa värde, utifrån perspektiv inom vårdforskning och tjänsteforskning. För det andra föreslår avhandlingen en dagboksbaserad metod för att involvera patienter i tjänsteinnovation. Deltagande patienter skriver i denna metod ner sina ner sina idéer och upplevelser varje dag under två veckors tid. Mina kollegor och jag utvecklade metoden i samarbete med personal från de deltagande vårdenheterna och applicerade den på praktiken. Erfarenheterna från projektet och de deltagande patienternas bidrag användes för att utforska möjligheterna med patientinvolvering i utvecklingen av vården. Vi föreslår tre sätt att lära sig från det insamlade materialet: som direkta idéer till förbättringar; summerat till rapporter för att ge kvalitativ förståelse av andra kvantitativa mätningar; och enskilda patienters berättelser kan användas för att förmedla patientperspektivet i organisationen och mana till förändring. För det tredje undersöker avhandlingen patienters motivation att bidra till tjänsteinnovation, ett hittills outforskat område. Genom en analys av patienters bidrag och genom intervjuer med deltagare finner vi att patienter motiveras att delta av en rad olika anledningar, från ett behov av upprättelse till en glädje av att utföra aktiviteten. Deltagandet uppfattas som en social och meningsfull händelse. Patienter upplever psykiskt välbefinnande och stöd genom att delta, även om sjukdom kan vara ett hinder i deltagandet. Avhandlingen undersöker även hur de allra mest motiverade patienterna kan identifieras och inkluderas i tjänsteinnovation, detta inspirerat av lead user-metoden (von Hippel, 1986). Sammantaget utforskar avhandlingen patientinvolvering och tjänsteinnovation från nya perspektiv och bidrar därmed till våra gemensamma ansträngningar för att förbättra vården och patienters välbefinnande.
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Deardorff, Karen Sickels. "Catalytic Innovations in Appalachia Ohio Health Care: The Storying of Health Care in a Mobile Clinic." Ohio : Ohio University, 2009. http://www.ohiolink.edu/etd/view.cgi?ohiou1245354639.
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Björkehag, Jonathan, and Kristin Seglare. "Innovationssystem för medicinsk teknik i Stockholm : En undersökning av centrala omständigheter för organisatorisk samverkan." Thesis, Södertörn University College, School of Business Studies, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-2747.
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Introduction In order to foster innovation of medical devices within the healthcare sector, a collaboration project, PUSH, has been initiated including the hospitals managed by the Stockholm County Council. The collaboration aims to capture ideas from employees and turn them into so called “high-practice” products as well as facilitate the possibilities for medical device companies to try out their products in the settings of healthcare. Collaborations for innovation, comparable to the PUSH project, can be found in both Swedish and foreign regions, but some of them fail to survive due to obstacles affecting the progress of each collaboration. Avoiding the same destiny will be a challenge to the PUSH project.
Purpose The purpose is to search for factors affecting organizational collaboration concerning innovation systems for medical device development. The study is focusing on ”high-practice” products within the PUSH project.
Theoretical approach In order to emphasize factors affecting innovation, theories regarding innovation systems, clusters and networks has been studied hence they all concern organizational collaboration.
Method The study’s qualitative approach is based on a semi deductive method. The analysis derives from a deductive outlook consistent with chosen theories, whereas collected data is used inductively to stress and enlarge part of the theoretical framework. Semi structured interviews, earlier research and evaluations constitutes most of the collected data.
Results and analysis Experience from collaborations for innovation shows that some affecting factors can’t be influenced by collaborators, as political decisions and medical device directives. Collaborators can however affect circumstances such as connections and networking, which is significant to manage the innovation process; from idea to commercialization. An explicit focus on commercialization is important to the collaboration project’s surviving opportunities. A central cause why innovation projects don’t last is lack of funding, both for commercializing certain products as well as for retaining and developing existing innovation structures.
Conclusion Collaborating projects should utilize existing structures and complement their networks to involve extensive competency. Decision makers need to decide whether innovation ventures shall be part of the County Council’s assignment. To fulfil the visions of the collaboration project, a policy common to all participants in the forthcoming innovation project needs to be stated, regarding ownership relations, risk sharing, funding and sharing of profits.
Bakgrund För att främja medicinteknisk innovation inom vården har ett utvecklingsprojekt för samverkan mellan Stockholms landstingsstyrda sjukhus påbörjats, under namnet PUSH (Produktutveckling inom Stockholms hälso- och sjukvård). Syftet med samverkan är att ta vara på landstingspersonalens idéer och utveckla s.k. high-practice-produkter samt att underlätta för medicintekniska företag att testa produkter i vårdmiljö. Liknande innovationssatsningar finns på olika håll i Sverige och utomlands, men det har varit problematiskt att få flera av dessa att överleva, då olika omständigheter påverkar utvecklingen av satsningarna. Samverkansprojektet mellan sjukhusen står således inför en rad utmaningar om de inte ska gå samma öde till mötes.
Syfte Syftet är att undersöka omständigheter som är centrala för organisatorisk samverkan inom innovationssystem för utveckling av medicinteknik. Utgångspunkten är utveckling av ”high-practice-produkter” inom projektet PUSH.
Teoretisk ansats För att belysa innovationspåverkande omständigheter i studien, har teorier om innovationssystem, kluster och nätverk studerats, utifrån att de behandlar organisatorisk samverkan.
Metod Studiens kvalitativa upplägg bygger på ett semideduktivt tillvägagångssätt. Utifrån ett deduktivt synsätt utgår analysen från befintliga teorier medan empirin på ett induktivt sätt ligger till grund för att framhålla och vidga delar av teorierna. Insamlad data utgörs till stor del av semistrukturerade intervjuer och tidigare undersökningar och utvärderingar.
Resultat och analys Erfarenheter från samverkansprojekt för innovationer visar att projekten påverkas delvis av omständigheter som ligger utanför projektens kontroll, som innovationspolitiska beslut och medicintekniskt regelverk. Påverkningsbara omständigheter är exempelvis att innovationsprojekt är beroende av ett välutvecklat kontaktnät som sträcker sig över hela innovationsprocessen, från utveckling av idén till kommersialisering. För långsiktig överlevnad är ett uttalat kommersialiseringsfokus av största vikt för projekten. En central orsak till att innovationsprojekt inte överlever på lång sikt är att det saknas finansiering, dels för kommersialisering av enskilda produkter och dels för att behålla och utveckla befintliga innovationsstrukturer.
Slutdiskussion För samverkansprojekt bör befintliga strukturer utnyttjas och kompletteras med en utvidgning av nätverket för att involvera en bredare kompetens. Beslutsfattare måste ta ställning till om huruvida innovationssatsningar ingår i landstingets uppdrag. En gemensam policy för ägarförhållanden och risktagande, finansiering och fördelning av eventuella vinster måste utarbetas om samverkansprojektets visioner ska kunna uppnås.
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Ottosson, Ulrika, and Siri Rönnlund. "Implementation of a Mobile Healthcare Solution at an Inpatient Ward." Thesis, KTH, Medicinteknik och hälsosystem, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-279145.
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Healthcare is a complex system under great pressure for meeting the patients’ needs. Implementing technology at inpatient wards might possibly support healthcare professionals and improve quality of care. However, these technologies might come with issues and the system might not be used as intended. This master thesis project investigates how healthcare professionals communicate at an inpatient ward and how this might be affected by implementing a Mobile Healthcare Solution (MHS). Further, it sought to question why healthcare professions might, or might not, use the MHS as a support of their daily work and what some reasons for this might be. Research methods were of qualitative approach. Field studies were performed at an inpatient ward and further, two healthcare professionals were interviewed. Grounded Theory (GT) was chosen as a method to process the data and obtain understanding for communication at the inpatient ward. The results showed that healthcare professionals communicate verbally, written and by reading, using different tools. The most prominent ways of communication were verbally, where it was common to report or discuss about a patient. The means for communication did not get drastically affected by implementing the MHS and reasons for this were of social, technical and organizational types. Some reasons for not using the MHS were habits and due to healthcare professionals perceiving the MHS as more time consuming than manual handling. However, a specific investigation of whether this might affect the usage of the MHS is yet needed
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Wass, Sofie. "The importance of eHealth innovations : Lessons about patient accessible information." Doctoral thesis, Internationella Handelshögskolan, Högskolan i Jönköping, IHH, Informatik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-38045.
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Access to digital information and communication has an increasing importance in both the work of healthcare professionals and in patients’ everyday life and has transformed what we do and how we carry out activities. It changes the way in which healthcare is delivered, how information is exchanged within and between organizations and how patients and other actors access and manage information. Currently, innovation is imperative in the healthcare sector and today there is a focus on how different eHealth services can improve healthcare. With increased access to various eHealth services, there is a need to know more about the impact of eHealth innovations on healthcare. The aim of this thesis is to acquire more knowledge about eHealth innovations in healthcare. The focus is on prerequisites to realize innovative eHealth services and eHealth services that provide patients with access to health information. The theoretical background addresses innovation, services and business models. This thesis is a compilatory work and includes five qualitative research papers. The first study is an interview study, the second is a literature review and the remaining three are case studies. The data collection consisted of interviews, surveys, workshops and secondary data collected from documents. The interview study and the case studies were performed in the Swedish eHealth setting. The research contributes to our understanding of eHealth innovations with insights on prerequisites to realize eHealth innovations and knowledge on patient accessible information. The first study provides a classification of prerequisites that need to be considered to realize innovative eHealth services. When dealing with eHealth services, organizational and sematic interoperability are still a challenge, and they transcend organizational boundaries. This thesis provides knowledge on the recent trend of opening up electronic health records to patients. The knowledge derived from the studies on patient accessible electronic health records show that there is a discrepancy between the perceptions of patients and healthcare professionals. The thesis concludes that patients feel more involved and that the patient-professional relationship improves with patient access to electronic health records, whereas healthcare professionals have concerns about how patients will manage access to health information. This thesis also provides empirical insights on how business models can be represented in a public eHealth setting. By viewing public eHealth services as social innovations, the thesis contributes to the research on business models in a public healthcare setting by incorporating societal value into the representation of the business model. The research in this thesis contributes to research in health informatics by discussing issues related to eHealth innovations and patient accessible information. Its practical importance lies in identifying issues that are important when discussing eHealth initiatives and the implications of giving patients online access to their electronic health record.
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Chama, Samson. "Program Approach for Childheaded Households in Zambia." VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1614.
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Using an emergent design, this study developed a program approach for young people in the child headed households of Zambia. Phase I dealt with prior ethnography, Phase II focused on independent living services, and Phase III concerned translation to Zambia. A total of 36 participants from Richmond, consisting of 20 Richmond Department of Social Services workers and youth and 16 Africans, were recruited. Three major themes emerged: feasibility, content, and quality. Lessons learned about translational research highlight the need for uniformity in a cultural screen’s composition. This might enhance the richness of perspectives on young people. Lessons for the Department of Social Services include a need to focus on tracking young people exiting services. This might involve exit interviews with young people and guidance with life decisions. There were lessons about decisions regarding local and expert knowledge in the translation process. This often becomes difficult when there are no assurances of participant uniformity. Paying attention to issues of local and expert knowledge would eliminate decision barriers that might arise during the translational process. Implications for social work education suggest that an emphasis on cultural competency might help students at the BSW and MSW levels to become better managers of adolescents. Implications for practice and policy include enhancing access to education and health for all young people. This process might be facilitated by the enactment of polices that highlight education and health for all young people at national and state levels. The following are crucial considerations for practice with young people: recruiting and training appropriate staff, promoting civic education, collaborating with young people, strengthening community involvement, strengthening agency collaboration, and developing targeted services. Implications for further research include: exploring what areas to consider when making a paradigm jump, considering cultural principles as bridges for making that jump, examining the implications for translational research as opposed to diffusion of innovation, determining what types of research samples would eliminate some of the gender issues that emerge with focus groups, recruiting more young people as participants, and conducting a study that focuses on lived experiences of young people.
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Boak, George Stewart. "The competencies of leaders of innovative change in health service organisations : an exploratory study." Thesis, University of Leeds, 2007. http://etheses.whiterose.ac.uk/1438/.
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This thesis contains an account of research into the competencies used by leaders of innovative change in health service organisations. A competency is defined as a capability that enables an individual to be effective in a task or a role. Leadership is defined as a process of influencing others to agree what needs to be done, and how it can be done, and assisting efforts to achieve the agreed aims. Innovative changes are changes that involve novelty to the organisation or group to which they are introduced. A qualitative approach was taken to the research. Interviews were carried out with forty executives and clinicians in UK and Australian health service organisations,who had been identified as effective in leading change. The interviews followed a Behavioural Event approach, based on the critical incident method, and the recordings and transcripts were subjected to a grounded analysis to derive descriptions of behaviours and competencies. Eleven competencies were identified from the interviews, including the ability to make sense of complex social systems, and the ability to work well in collaboration with others. The eleven competencies were used in combination in a range of leadership styles that were participative, collaborative, persuasive, transactional, pragmatic, personable and managerial. The majority of interviewees described bringing about effective change using styles that were not visionary - and therefore that did not employ what is often regarded as a central element of the leadership of change, and of transformational leadership, that of an appealing vision of the future. No significant differences in the competencies employed were found between UK and Australian interviewees in comparable roles.
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Björkehag, Jonathan, and Kristin Seglare. "Karolinska Testbädd för Telemedicin och eHälsa : En analys av medicintekniska företags behov och krav på en samverkansmiljö för produktutveckling på Karolinska Universitetssjukhuset." Thesis, Södertörns högskola, Institutionen för ekonomi och företagande, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-4828.
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Syftet med uppsatsen är att kartlägga behovet av en testbädd för telemedicinska produkter och att analysera krav som medicintekniska företag ställer på en testbäddsmiljö för samverkan med sjukvården. Målet har varit att konkretisera resultatet i en kommersialiseringsplan för Karolinska Testbädd för Telemedicin och eHälsa, vid Medicinsk Teknik på Karolinska Universitetssjukhuset. Vid genomförandet av undersökningen har totalt 19 intervjuer och ytterligare 6 telefonintervjuer genomförts med dels representanter från medicintekniska företag och sjukvården och dels med samarbetsstrukturer för medicinsk teknik och möjliga finansiärer. En enkätundersökning har genomförts för att kvantifiera resultatet från intervjuerna. Webbutskick har gjorts till 279 företag med verksamhet inom områdena medicinsk teknik, IT och telekom. Uppsatsen beskriver hur den kliniska forskningen inom området medicinsk teknik har förändrats de senaste decennierna och hur situationen ser ut idag. Utmaningar som den svenska hälso- och sjukvården står inför presenteras, som demografiska förändringar, ökade sjukvårdskostnader, dyrare behandlingsmetoder och färre kommersialiserade innovationer inom medicinsk teknik. Omständigheter som påverkar produktutveckling för hälso- och sjukvården belyses, dels genom den regulatoriska gränsdragningen mellan IT-produkter och medicintekniska produkter och dels utifrån en genomgång av forskning inom produkt- och tjänsteutveckling och utifrån de frågor kring hur företag bedriver produktutveckling som ställts i intervjuerna och i webbenkäten. Resultatet visar att företagen i högsta grad är beroende av samarbete med sjukvården i olika faser av sin produktutvecklingsprocess och att flera företag uttrycker ett behov av en testbäddsstruktur. Företagen samarbetar med vården framförallt för att det möjliggör att utveckla mer vårdanpassade produkter. Samarbete med vården ger kortare utvecklingstider och därmed minskade utvecklingskostnader. Det förenklar även arbetet med validering av produkters funktionalitet. Flera företag har utarbetade samarbeten direkt in på vårdavdelningar, medan andra i dagsläget saknar nödvändiga samarbetsstrukturer. Studien har identifierat ett flertal företag som visat intresse för ett samarbete med Testbädden och ytterligare ett antal som har önskat att få mer information om vad Testbädden kan erbjuda. I kommersialiseringsplanen föreslås Karolinska Testbädd för Telemedicin och eHälsa fokusera på sin nisch samt vidareutveckla den kompetens som företagen saknar. Testbädden bör arbeta vidare med att utveckla både externa kontakter och den interna samverkansorganisationen på Karolinska för att möjliggöra effektiva, smidiga och kvalitativa samarbeten mellan företag och sjukhusets avdelningar.The purpose is to study the demand for a testbed for telemedicine and to analyze the medical device-developing companies’ requirements on the testbed’s facilities when collaborating with the healthcare sector in their product development. The study’s aim is to result in a commercialization plan for Karolinska Testbed for telemedicine and eHealth, at the department of Biomedical Engineering at Karolinska University Hospital. During the study, 19 interviews and 6 telephone-interviews has been held with people from the medical device industry, hospitals, potential funders and collaboration structures which foster medical device development. A web-survey has been sent to 279 companies within the fields of medical technologies, IT and telecom, to quantify the results from the interviews. The study describes how the clinical research on medical technologies has changed over the last decades and what the situation is like today. Present and forthcoming challenges to the Swedish health care system is presented, like demographic changes, increasing healthcare-costs, expensive treatments and the scarcity of medical device innovations being commercialized. Obstacles affecting the medical device development are studied, including the regulatory differences between IT and medical devices. An analysis of the research on product and service development is also looked at from the perspectives on how the medical device companies develop their products, which is derived from both interviews and the web-survey. The result shows that medical device companies rely upon the ability to collaborate with the hospitals in different phases of their product development process and that there is an extensive need for a testbed structure amongst companies. The companies that collaborate with hospitals do it primarily because it makes their products more adaptive to functioning in the settings of healthcare, time to market and development costs can be decreased and it facilitates the process when validating the functionality of their products. Several companies have their ways of collaborating with hospital wards whilst others explicitly lack indispensable collaboration structures. The study has identified some companies which have shown interest in collaborating with Testbed Karolinska for telemedicine and eHealth and other ones whom wish to receive more information on what the testbed can offer them. In the commercialization plan it is suggested that Karolinska Testbed for telemedicine and eHealth shall focus on their niche and elaborate the competency which the companies doesn’t have. It is also suggested that the Testbed continues the work with developing the internal organization within Karolinska to enable efficient, flexible and qualitative collaboration between companies and the clinics at Karolinska University Hospital.
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Летуновська, Наталія Євгенівна, Наталия Евгеньевна Летуновская, and Nataliia Yevhenivna Letunovska. "Marketing innovations in the tourism product of the sphere of health and treatment." Thesis, Kharkiv State University of Food Technology and Trade, 2020. https://essuir.sumdu.edu.ua/handle/123456789/80664.
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У тезах розглядають сучасні підходи до просування послуг медичного туризму. Автор наводить конкретні приклади інструментів, що сприяють поширенню інформації про продукт цільовим споживачам медичних послуг.В тезисах рассматриваются современные подходы к продвижению услуг медицинского туризма. Автор приводит конкретные примеры инструментов, которые помогают распространять информацию о продукте целевым потребителям медицинских услуг.
Theses consider modern approaches to the promotion of medical tourism services. The author gives specific examples of tools that help disseminate information about the product to target consumers of medical services.
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Brantnell, Anders. "Exploitation of University-Based Healthcare Innovations : The Behaviors of Three Key Actors and Influencing Factors." Doctoral thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-317934.
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Large resources are invested in healthcare research, but despite this there is a wide gap between research knowledge and healthcare practice. Implementation researchers have addressed this gap, focusing mostly on the role of healthcare practitioners. However, a narrow focus on implementation does not take into consideration the preceding stages and the roles of different actors during the whole innovation process, which starts from research and ends with implementation. The aim of this thesis is to examine the behaviors of three key actors during an innovation process and to explore the influence of selected contextual factors on their behavior. Study I (n=10 funders) identifies several facilitative roles for funders and suggests that implementation risks becoming no one’s responsibility as the funders identify six different actors responsible for implementation, the majority of whom embody a collective or an organization. Study II finds that the implementation knowledge of Swedish funding managers (n=18) is mostly based on experience-based knowledge. The majority of the funding managers define implementation as a process and express limited knowledge of implementation. The findings of Study III (n=4 innovation cases) show that the roles and involvement of academic inventors and ISAs (innovation-supporting actors) are more connected to intellectual property (IP) nature than to intellectual property rights (IPR) ownership. Study IV (n=4 innovation cases) identifies three different logics that influence the behavior of academic inventors: market, academic and care logics. A pattern emerges where the behavior of academic inventors is guided by a unique logic and there is no interaction between logics, despite the existence of multiple logics. The individual strategies to handle multiple logics coincide with the influence of logics. In addition, IP nature, distinguishing between high-tech and low-tech innovations, is connected to the influence of institutional logics: low-tech connected to the care logic and high-tech connected to the market logic. This thesis has three main theoretical and practical implications relevant for practitioners, policymakers and researchers. First, implementation responsibility is an important issue to study and discuss, because without clearly defined responsibilities and management of responsibilities, responsibility might become no one’s responsibility. Second, the finding that experience-based implementation knowledge contributes heavily to policymakers’ knowledge encourages further studies and discussions regarding this relatively neglected issue. Third, the importance of IP nature in shaping innovation processes should be considered and further examined, not only as a factor influencing inventors and ISAs’ roles and involvement, but also as influencing the prevalence of different institutional logics. Further, the relevance of a distinction between low-tech and high-tech IP should be reflected on.
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Ellison, Jeffrey H. "Rural Parents Mental Health Service Delivery Preferences: Overcoming Barriers to Care." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etd/1334.
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Unique barriers prevent parents in rural areas from seeking mental health services for their children. The implementation of innovative models of service delivery may reduce these barriers' impact on rural parents' treatment seeking.
The purpose of this study was to determine: 1) parents' willingness to use innovative service delivery models; 2) barriers that parents perceive to seeking treatment in each of the 4 service delivery models, and; 3) the relationship between perceived barriers and willingness to seek help in the context of 4 service delivery models.
Surveys were distributed to parents of children attending school in several counties in rural Appalachia.
Results showed that parents perceived different barriers for different service models and that perceived barriers affected willingness differently depending on the model asked about.
These results suggest that the use of innovative models (e.g., telehealth) may be acceptable in rural areas as alternatives to traditional mental health services.
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Mostert-Phipps, Nicolette. "Health information technologies for improved continuity of care: a South African perspective." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1619.
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The fragmented nature of modern health care provision makes it increasingly difficult to achieve continuity of care. This is equally true in the context of the South African healthcare landscape. This results in a strong emphasis on the informational dimension of continuity of care which highlights the importance of the continuity of medical records. Paper-based methods of record keeping are inadequate to support informational continuity of care which leads to an increased interest in electronic methods of record keeping through the adoption of various Health Information Technologies (HITs). This research project investigates the role that various HITs such as Personal Health Records (PHRs), Electronic Medical Records (EMRs), and Health Information Exchanges (HIEs) can play in improving informational continuity of care resulting in the development of a standards-based technological model for the South African healthcare sector. This technological model employs appropriate HITs to address the problem of informational continuity of care in the South African healthcare landscape The benefits that are possible through the adoption of the proposed technological model can only be realized if the proposed HITs are used in a meaningful manner once adopted and implemented. The Delphi method is employed to identify factors that need to be addressed to encourage the adoption and meaningful use of such HITs in the South African healthcare landscape. Lastly, guidelines are formulated to encourage the adoption and meaningful use of HITs in the South African healthcare landscape to improve the continuity of care. The guidelines address both the technological requirements on a high level, as well as the factors that need to be addressed to encourage the adoption and meaningful use of the technological components suggested. These guidelines will play a significant role in raising awareness of the factors that need to be addressed to create an environment conducive to the adoption and meaningful use of appropriate HITs in order to improve the continuity of care in the South African healthcare landscape.
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Rasia, Isabel Cristina Rosa Barros. "Relação entre as forças internas e externas na inovação em serviço na atenção primária à saúde." reponame:Repositório Institucional da UCS, 2015. https://repositorio.ucs.br/handle/11338/1310.
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Esta Tese tem, como tema central, a inovação em serviço na Atenção Primária à Saúde (APS) e, como objetivo, analisar a relação entre as forças internas e externas na inovação em serviço na APS de Pelotas, caracterizando a sua forma de organização e gestão, os processos estabelecidos para inovar, sua orientação em APS e as inovações geradas/produzidas nas dimensões: produto, processo, marketing e organizacional (Manual de Oslo, 2005). Cada dimensão foi analisada nas perspectivas:estrutura física, recursos humanos, equipamentos, medicamentos e materiais, acesso a exames complementares, gestão e atendimento ao usuário. Inovações em serviços de saúde têm como premissa, a melhoria da produtividade e eficiência, o aumento da qualidade e da capacidade de resposta, a redução das variabilidades na prática assistencial e a ampliação do acesso aos serviços de saúde. A APS compreende o primeiro nível de contato dos indivíduos, da família e da coletividade, com o sistema de saúde. O método de investigação teve um delineamento transversal, objetivo exploratório e, quanto à natureza de abordagem quantitativa e qualitativa. Realizou-se um estudo de casos com a aplicação de pesquisa empírica à população de gestores ligados ao sistema de saúde da APS da cidade com perguntas sobre a conformação do sistema de saúde, a inovação em serviços e sua orientação em APS de acordo com o Primary Care Assessment Tool, instrumento validado por Starfield (2001) e Brasil (2010). Os resultados quantitativos demonstram que as inovações em serviços eram, em maioria da tipologia produto (98%), processo (90%), e organizacional (88%) e em menor proporção a de marketing (32%). Em todas as dimensões, as perspectivas com mais inovações estavam ligadas à gestão, atendimento ao usuário e recursos humanos. Em relação ao desfecho “Orientação em APS”, a média geral de 6,91 (dp = 1,12) demonstrou que as UBS do município estão orientadas em APS.Contudo, quando se estratifica por modelo de atenção, as UBS que trabalham com a Estratégia de Saúde da Família (ESF) estão orientadas com escore de 7,51 (dp = 0,71), enquanto que as Tradicionais obtiveram uma média de 5,91 (dp = 0,95), consideradas não orientadas em APS (p = 0,000). Quanto à associação das inovações e à orientação em APS, constatou-se na análise bruta por Regressão de Poisson, pertencer ao modelo de atenção às variáveis ESF, ter planejamento de ações e organização formal das atividades, as quais estiveram significativamente associadas à orientação em APS.No entanto, na análise ajustada, apenas a variável modelo de atenção permaneceu associada ao desfecho (2,86; IC 95% 2,18 – 6,91). A análise qualitativa identificou que o município atua sob o modelo de gestão plena do Sistema Municipal de Saúde e os processos de inovação em serviço são alavancados através do Governo Federal, sendo os programas e projetos lançados a nível nacional, com a adesão da Secretaria Municipal de Saúde (SMS), desenvolvidos com a participação efetiva das equipes de saúde das Unidades Básicas de Saúde (UBS), através do planejamento e da formalização, amparadas pela comunidade adscrita, Universidades, Conselho Municipal de Saúde (CMS) e Conselho Local de Saúde (CLS).Submitted by Ana Guimarães Pereira (agpereir@ucs.br) on 2016-09-15T17:12:58Z No. of bitstreams: 1 Tese Isabel Cristina Rosa Barros Rasia.pdf: 10235240 bytes, checksum: 3569ed6ea040f96692e34d526f178db3 (MD5)
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This thesis focuses on the innovation in services at Health Primary Attention (HPA) andaims at analyzing the relationship between internal and external forces in the innovation in services at HPA in Pelotas, describing its organization and management ways, the procedures established for innovating, its guidance on the HPA, and the innovation generated/produced on the following dimensions: product, process, marketing, and organizational area (Manual de Oslo, 2005). Each dimension was analyzed under perspectives as follows: physical structure, human resources, appliances, medicines and materials, access to complementary examinations, management, and user service. Innovation on health services assumption is the improvement of production and efficiency, the increase on quality and responsiveness, the reduction on variation in care practice, and the increase of access to health services. The HPA includes the individual’s, family, and collectivity first level of contact with the health system. Research was performed through a cross-sectional, objective, exploiting method under a quantitative, qualitative nature of approach. A case study was conducted by the application of an empirical research to the population of managers linked to the health system of the local HPA asking about the health system forming, innovation in services, and its guidance on the HPA according to the Primary Care Assessment Tool, a tool validated by Starfield (2001) and (2010).Quantitative results show that the innovation in services were, as to their typology, mostly: product (98%), process (90%), and organizational (88%), and fewest in marketing (32%). In all dimensions, the perspectives presenting more innovations were connected to management, user care, and human resources. Regarding to “HPA orientation” outcome, the general average 6.91 (SD = 1,12) indicated that the local “UBS” are arranged in HPA. However, when stratified according to the attention model, the “UBS” working with the Family Health Strategy (FHS) scored 7.51 (SD = 0.71),while Traditional ones averaged 5.91 (dp = 0.95), considered as not guided in HPA (p = 0,000). As to the association of innovations and orientation in HPA it was seen under the gross analysis by Poisson Regression that they belong to the model that pays attention to FHS variables, which were significantly related to the orientation in HPA. In the adjusted analysis, however, only the variable attention model remained related to the outcome (2.86; IC 95% 2.18 – 6.91). The qualitative analysis identified that the county performs the full management model of its Municipal Health System and the processes of innovation in services are leveraged by the Federal Government, being the programs and projects launched at national level, along with the Municipal Secretariat of Health, developed with the effective participation of health teams from the Basic Unit of Health (BUH), based on planning and formalization, supported by the assigned community, Universities, Municipal Council of Health (MCH), and the Local Council of Health (LCH).
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Yingyi, Lu. "Investigation of the Process for Generating Evidence for Innovations in Medical Technology." Thesis, KTH, Medicinteknik och hälsosystem, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-297527.
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Health technology assessment (HTA) is a process that evaluates the value and effects of health technology during its life cycle and provides scientific information to decision makers. However, the chasm between healthcare and innovation has been highlighted in several research areas. HTA as a bridge connecting the research and decision-making demands, achieving more transparent processes and high quality of evidence to enable more effective and safer MedTech innovations to reach and benefit healthcare and patients. This thesis aims to examine the current status of HTA across different countries compared to Sweden to identify the major hurdles and enablers in this process and any opportunities for learning across systems. Germany, the United Kingdom, and Finland are three countries being compared to Sweden in the thesis. A literature review combined with interviews were the main methodologies used for this project. Peer-reviewed literature, government documents, and official websites gave an overview of the HTA systems in selected countries and laid a solid foundation for the more in-depth interviews. Eight interviews (nine interviewees) with HTA agencies and companies were performed via Zoom, along with an email communication(one interviewee) with Fimea. The interviews were used as a support tool to gain a better understanding of the whole HTA system. Some personal opinions were also helpful to gain a view of the system from an alternative, more practical perspective. The results show the different HTA processes and the evidence generation paths in four countries. Views from MedTech companies are also given. The HTA in Sweden has two main pathways: SBU and TLV. These two agencies have particular traits that work differently with distinct purposes. In terms of the evidence generation and assessment methods, they also share different points of view. It is difficult to simply compare these systems in parallel due to the system's complexity and different healthcare conditions in every country. But all countries, including Sweden, should realize the challenges ofthe existing HTA systems, and try to reduce the evidence generation gap between expectation and reality. This would create more opportunities for small MedTech companies to be involved in the process, and actively participate in international HTA cooperation.Hälsoteknikutvärdering (HTA) är en process som utvärderar värdet och effekterna avhälsoteknik i dess livscykel och ger vetenskaplig information till beslutsfattare. Klyftanmellan hälso- och sjukvård och innovation har dock lyfts fram inom fleraforskningsområden. HTA länkar forskning och beslutsfattande genom att möjliggöramer transparenta processer och hög kvalitet på bevis för effektivare och säkrareMedTech-innovationer att nå och gynna sjukvård och patienter. Denna uppsats syftartill att undersöka HTA:s nuvarande status i olika länder jämfört med Sverige för attidentifiera de största hindren och möjliggörare i denna process och eventuellamöjligheter till lärande i olika system. Tyskland, Storbritannien och Finland är treländer som jämförs med Sverige i avhandlingen. Litteraturöversikt och intervjuer är de huvudsakliga metoderna som används för dettaprojekt. Forskargransakad litteratur, regeringsdokument och officiella webbplatser gaven översikt över HTA-systemen i utvalda länder och lade en solid grund för följandeintervjuer. Åtta intervjuer (nio intervjuade) med HTA-byråer och MedTech-företaggenomfördes via Zoom, tillsammans med en e-postkommunikation med Fimea.Intervjuerna användes som ett stödverktyg för att ge en bättre förståelse för hela HTAsystemet.Vissa personliga åsikter gav tillfälle att förstå HTA från ett alternativtperspektiv jämfört med dess beskrivning i litteraturen. Resultaten visar olika HTA-processer och bevisgenereringsvägar i fyra länder, samtsynpunkter från MedTech-företag. HTA i Sverige har två huvudvägar: SBU (viaregionala HTA centra) och TLV. Dessa två vägar har speciella egenskaper som fungerarannorlunda och med olika syften. När det gäller bevisgenerering ochbedömningsmetoder skiljs de även åt. Det är utmanande att jämföra dessa systemparallellt på grund av systemets komplexitet och olika sjukvårdsförhållanden i varjeland. Men alla länder, inklusive Sverige, bör inse brister i befintlig HTA och försökaminska bevisgenereringsgapet mellan förväntan och verkligheten. Under tiden skapasfler möjligheter för små MedTech-företag att delta i processen och delta aktivt iinternationella HTA-samarbeten.
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Nodari, Cristine Hermann. "Dinâmica da inovação no serviço público da atenção primária à saúde." reponame:Repositório Institucional da UCS, 2013. https://repositorio.ucs.br/handle/11338/916.
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A teoria sobre inovação tem se desenvolvido, intensamente, nas últimas décadas, incluindo a análise da inovação em serviços públicos de saúde. Doravante, o setor de serviços representa em diversos países, inclusive no Brasil, taxas de crescimento anuais superiores a todos os demais setores da economia. A Atenção Primária à Saúde (APS) constitui a essência da reorientação e reestruturação de muitos sistemas de saúde (OPAS, 2005), pois atua como um núcleo organizador e integrador de serviços de rede e de promoção, prevenção e recuperação da saúde. Diante da relevância das questões pautadas pela finalidade de incentivo à melhores condições de saúde nas populações, a partir da rede complexa da APS (MENDES, 2007), e da importância da compreensão da inovação em serviços para as organizações, o objetivo dEsta tese foi analisar a dinâmica das inovações no serviço público da APS. Considerando o ambiente público, propôs – se que a APS possui uma lógica estruturada para o desenvolvimento das inovações a partir de interações constantes entre diferentes agentes na produção do serviço. Para atingirmos essa proposição central, ocorreu a necessidade de conceber, holisticamente, o desenvolvimento, integrações e repercussões da inovação neste setor. A metodologia utilizada foi de uma pesquisa exploratória e descritiva dividida em duas etapas. A primeira etapa da pesquisa utilizou uma entrevista semiestruturada para identificação da tipologia da inovação no setor e entendimento sobre o processo de inovação. Também, utilizou, um questionário estruturado para análise da qualidade do serviço sob orientação da APS. Para a segunda etapa de pesquisa foi aplicado outro questionário estruturado a fim de se identificar as capacidades e preferências mobilizadas pelos agentes para ocorrência de inovações. Fez – se uso de análise multivariada dos dados coletados envolvendo técnicas qualitativas e quantitativas considerando as duas etapas. Os principais resultados apontam para a identificação de cinquenta e seis inovações nas quais estão relacionadas a qualidade do serviço sob orientação da APS. Também, evidenciam uma preponderância da capacidade dos servidores na mobilização das inovações o que permite configurar o processo de inovação no serviço público da APS contribuíndo no delineamento de uma abordagem baseada em evidências para a inovação.Submitted by Ana Guimarães Pereira (agpereir@ucs.br) on 2015-03-17T17:33:43Z No. of bitstreams: 1 Tese Cristine Hermann Nodari.pdf: 203392 bytes, checksum: b0dae7a8ed0459ae93791186a14b12bc (MD5)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES
The theory of innovation has developed intensively in recent decades, including the analysis of innovation in public health. Moreover, the services sector accounts in several countries, including Brazil , annual growth rates in excess of all other sectors of the economy. The Primary Health Care (PHC) is the essence of the reorientation and restructuring of many systems (OPAS, 2005), it acts as a core organizer and integrator of network services and promotion, prevention and rehabilitation of health. Given the importance of the issues guided by the aim to encourage better health in populations from the complex network of APS (MENDES, 2007), and understanding the importance of innovation in services for organizations , the aim of this thesis was to analyze the dynamics of innovation in the public service of APS. Considering the public environment, it was proposed that the APS has a structured logic for the development of innovations from ongoing interactions between different agents in the production of the service. To achieve this central proposition was the need to design holistically development, integration and impact of innovation in the service sector. The methodology used was an exploratory and descriptive divided into two stages of research. The first stage of the research used a semistructured interview to identify the typology of innovation in the industry and understanding of the innovation process. Also, we used a structured questionnaire to analyze the quality of the service under the guidance of APS. The second stage of the survey provided for the use of a structured questionnaire in order to identify the capabilities and preferences mobilized by agents for the occurrence of innovations. Made use of multivariate analysis of the collected data involving qualitative and quantitative techniques considering two steps. The main results show the identification of fifty six innovations related to quality of service under the guidance of APS. Also show a preponderance of server capacity in mobilizing innovation that permits configuring the innovation process in the public service of APS contributing in the design of an evidence – based approach to innovation.
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Lindermann, Nadine [Verfasser]. "Open Health Service Innovations mit Web 2.0 : Design-Ansatz für den Einsatz von Web 2.0 zur Generierung offener Gesundheitsdienstleistungsinnovationen / Nadine Lindermann." Aachen : Shaker, 2016. http://d-nb.info/1124366032/34.
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Jego, Maéva. "Améliorer la santé des personnes sans chez-soi : vers quelles innovations organisationnelles en soins primaires ?" Thesis, Aix-Marseille, 2019. http://www.theses.fr/2019AIXM0211/document.
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Objectif : identifier de nouvelles formes d’organisation et adaptations à développer en soins primaires pour améliorer la prise en charge des personnes sans chez-soi (PSCS).Méthode : recherche mixte. une première phase a exploré les ressentis des médecins généralistes (MG) sur leur place dans la prise en charge des PSCS. La seconde phase a consisté à décrire, par une revue de la littérature, les principales composantes des programmes de soins primaires prenant en charge les PSCS, et identifier les plus pertinentes. La dernière phase a exploré le vécu et les représentations des PSCS vis-à-vis des soins premiers.Résultats : les médecins généralistes relevaient la complexité des prises en charge et le besoin d’une coordination médico-psycho-sociale renforcée. Dans la littérature, la quasi-totalité des programmes prenant en charge les personnes sans chez-soi privilégiaient cette approche pluridisciplinaire coordonnée. Les caractéristiques associées à des impacts positifs pour les PSCS étaient : la spécialisation dans leur prise en charge, l’accompagnement, les approches multidisciplinaires, l’implication d’infirmières dans la prise en charge, l’intégration de services d’aide sociale, et l’engagement dans la santé communautaire. Les entretiens auprès des PSCS ont relevé l’importance des attentes relationnelles : plus qu’une réponse médicale, ils souhaitent être écoutés, considérés et compris.Conclusion : les programmes de soins primaires souhaitant prendre en charge PSCS devraient privilégier une approche pluridisciplinaire et décloisonnée des soins de santé physique, mentale, et de la prise en charge sociale de ces patients, en privilégiant une approche centrée-patientAim: to identify new forms of organization and adaptations to develop in primary care to improve the care of Homeless People (HP).Method: research by mixed methods. In the first phase we explored the views of general practitioners (GPs) about how they can provide care to HP. In the second phase we led a literature review, to describe the main characteristics of the primary care programs that take care of homeless people, and to identify which could be most relevant. In the third phase, we explored the experience and views of HP about primary care.Results: GPs expressed the need to develop medical and psychosocial approach with closer relation with social workers. In the litterature, almost all homelessness programs developed a multidisciplinary approach and / or offered co-located mental health, physical health and social services. Some characteristics were associated with significant positive outcomes: tailored primary care organizations, clinic orientation, multidisciplinary team-based models which included primary care physicians and clinic nurses, integration of social support, and engagement in the community’s health. The interviews with HP showed central relational expectations of HP for their general practitioner. More than a medical response, they expected to be listened to, considered and understood.Conclusion: Primary care programs that wish to better care for HP should develop a multidisciplinary, medico-psycho-social approach. The patient-centered approach appears warranted to improve the care experience of these patients
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Larsson, Eva. "Innovationsvårdcentralens tillkomst : Medarbetares erfarenheter från ett förändringsarbete inom primärvård." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-23597.
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Ett omställningsarbete pågår inom Sveriges regioner, som bl.a. innebär att primärvårdens roll ska stärkas, finnas nära patienterna, vara lättillgänglig och effektiv. Inom Västra Götalandsregionen pågår omställningsarbetet på olika sätt. Ett omfattande förändringsarbete pågår vid en vårdcentral som sedan länge haft behov av förändring p.g.a. hög personalomsättning, svårigheter att rekrytera kompetent personal samtidigt som medarbetarna som arbetade kvar fick en sämre arbetssituation. Ortens invånare och vårdcentralens patienter påverkades genom en försämrad kontinuitet. På vårdcentralen har förändringsarbetet startat och man arbetar numera med både forsknings-, utvecklings- och innovationsarbeten. Det saknades en förståelse för medarbetarnas erfarenheter från förändringsarbetet. Syftet med denna studie var att beskriva medarbetarnas erfarenheter från den process som vårdcentralens förändringsarbete inneburit. Ett förändringsarbete som har lett till att benämnas som en innovationsvårdcentral. För att kunna beskriva erfarenheterna gjordes en kvalitativ intervjustudie med sex informanter från vårdcentralens fyra yrkeskategorier. En manifest innehållsanalys med en induktiv ansats har använts. Resultatet beskriver en tilltro till vårdcentralens förändringsarbete där informanterna känt sig delaktiga. I början av förändringsprocessen fanns en viss oro över att förändra invanda arbetssätt även om informanterna ansåg att förändringarna var nödvändiga. Förnyade arbetssätt har medfört att man arbetar mer effektivt, vilket både medarbetarna och patienterna har nytta av. Behovsanpassad utbildning har genomförts och kompetensutveckling bidrar till att medarbetarna får till sig nya forskningsrön, vilket kan ge patienterna en bättre vård. Resultatet stämmer väl överens med tidigare forskning vilket gör att studiens resultat kan bidra till att utvärdera det förändringsarbete som görs på vårdcentralen, samtidigt som resultatet kan vara betydelsefullt för framtida bildningar av innovationsvårdcentraler.