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  • 1.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andreasson, Jörgen
    KTH.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Nyorientering av svensk sjukvård: Verksamhetstjänande implementeringslogiker bygger mer hållbart engagemang och utveckling - i praktiken2016Report (Other academic)
  • 2.
    Dellve, Lotta
    et al.
    University of Borås, Sweden.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andreasson, Jörgen
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Holden, Richard
    Lean implementation approaches at different levels in Swedish hospitals: the importance for working conditions, worker engagement, health and performance2014Conference paper (Refereed)
    Abstract [en]

    Background

    Swedish healthcare organizations are investing heavily in internal reforms. Lean has been frequently used as an overall concept to improve care processes and decrease costs. Some evidence shows positive results, especially if work environment issues are considered in parallel with other desired outcomes. However, there are considerable difficulties in evaluating lean as a concept since its application and interpretation seem to vary widely. Further, like for other management concepts, lean outcomes crucially depend on the implementation process.

    Aim

    This program investigates implementations of lean and lean-like developments of processes of care, and how these affect the working conditions, health, and performance of healthcare employees. We also investigated organizational factors and conditions that mediated specific outcomes.

    Method

    Mixed method design: questionnaire to employees (n=880) and managers (n=320), qualitative interviews (n=55) and observations with follow up during three years. Five hospitals were selected, and within them five units that were connected by their flow of acute care patients, i.e. the emergency unit, the medical and surgical emergency ward (or ICU at small hospital) as well as one medical and one surgical ward. Initially we used qualitative-driven analyses and thereafter quantitative-driven mixed method analysis.

    Results

    The implementation strategies varied between the hospitals and between the strategic and operative levels. Strategic managers also used different approaches to overcome the gap between strategic and operative levels. Operative managers shared similarities in their stepwise and coaching approaches encouraging participation among employees, but differences regarding how assignments were delegated. Social capital and attitudes among health care profession were of importance for employees’ work engagement and active engagement in development work.

  • 3.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH). Gothenburg University, Sweden.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Holden, Richard J.
    School of Informatics and Computing, Indiana University, Indianapolis, US.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health care clinicians' engagement in organizational redesign of care processes: Health care clinicians' engagement in organizational redesign of care processes2018In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 68, p. 249-257Article in journal (Refereed)
    Abstract [en]

    The Swedish health care system is reorienting towards horizontal organization for care processes. A main challenge is to engage health care clinicians in the process. The aim of this study was to assess engagement (i.e. attitudes and beliefs, the cognitive state and clinical engagement behaviour) among health care clinicians, and to investigate how engagement was related to work resources and demands during organizational redesign. A cohort study was conducted, using a questionnaire distributed to clinicians at five hospitals working with care process improvement approaches, two of them having implemented Lean production. The results show that kinds of engagement are interlinked and contribute to clinical engagement behaviour in quality of care and patient safety. Increased work resources have importance for engagements in organizational improvements, especially in top-down implementations. An extended work engagement model during organizational improvements in health care was supported. The model contributes to knowledge about how and when clinicians are mobilized to engage in organizational changes.

  • 4.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Holden, Richard
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Lean implementation at different levels in Swedish hospitals: the importance for working conditions and stress2015In: International Journal of Human Factors and Ergonomics, ISSN 2045-7812, Vol. 3, no 3-4, p. 235-253Article in journal (Refereed)
    Abstract [en]

    Healthcare organisations in Sweden are reorienting toward horizontal organisation around care processes. This paper's aim was to investigate how implementation approaches for improvements of care processes in line with lean production (LP), at hospital strategic and operative levels, are associated with working conditions and stress-related health among the employees. Five hospitals working with improvements to care processes were studied using questionnaires to employees (n = 1,303) and interviews at strategic and operative levels at baseline and follow-up. The process redesign implementation strategies varied between the strategic and operative levels. There were associations between a higher degree of LP at operative level and increased work resources and decreased work demands. Physical, cognitive and mental stress-related symptoms were only weakly associated with strategic or operative LP initiatives. There was evidence of more beneficial or improved working conditions in relation to higher degree of LP at operative levels.

  • 5.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    Strömgren, Marcus
    KTH.
    Emma, Edström Bard
    Utveckling av hållbart och hälsofrämjande ledarskap –  i vardag och förändring: Utvärdering av interaktiv metodik för företagshälsovårdsdrivna interventioner2016Report (Other academic)
  • 6.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Experiences of Implementing Occupational Health Services Driven Intervention Methods for Sustainable Leadership in Health Care2016In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 28, p. 50-51Article in journal (Other academic)
  • 7.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Intention to leave among health care professionals: The importance of working conditions and social capital2017In: Journal of Hospital Administration, ISSN 1927-6990, E-ISSN 1927-7008, Vol. 6, no 3, p. 58-66Article in journal (Refereed)
    Abstract [en]

    Hospitals in Sweden are redesigning their care processes to increase efficiency. However, related to these changes, there is a risk of increased staff intention to leave and turnover due to increased workload and work pace. The literature on work engagement and job demands and resources suggests that specific job resources can buffer negative effects; i.e., intention to leave because of job demands. Social capital is suggested to have the potential to be a resource associated with staff intention to leave. The aim of this study was to investigate the associations between social capital and intention to leave and to test if social capital  moderates the relationship between job demands and intention to leave. A sample of five hospitals working under conditions of improvements of care processes were studied using a questionnaire administered to the healthcare clinicians (n = 849). High levels of social capital were associated with low levels of intention to leave. However, the moderating effect of social capital was not confirmed. Intention to leave among occupational groups was influenced differently by social capital, other job resources, and job demands.

  • 8.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Social capital in healthcare: A resource for sustainable engagement in organizational improvement work2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Social capital, work engagement, working conditions, and leadership are concepts that have been studied previously, but there is lack of knowledge about what processes promote sustainable organizational improvement work in hospitals, and specifically, what leads healthcare professionals to engage in clinical developments.

    The overall aim of this thesis is to increase knowledge of how social capital and engagement contribute to sustainable organizational improvement work in hospitals and how social capital and engagement are created during organizational improvement work. Data were collected by a questionnaire at three times over a period of two years at five hospitals and all studies are quantitative.

    The results show that improved working conditions and employees’ attitudes to engagement in improvement work are associated with and have importance for healthcare professionals’ work engagement and clinical engagement in improving care processes (Study I). Job demands, social capital, and other job resources are associated with healthcare professionals’ intention to leave their jobs, whereas high levels of social capital are associated with low levels of intention to leave (Study II). Increased social capital predicted healthcare professionals’ job satisfaction, work engagement, and engagement in patient safety (Study III). Leadership is shown to be important for healthcare professionals’ social capital, and levels of leadership quality correlate with levels of social capital over time (Study IV).

    In conclusion, social capital, increased job resources, and decreased job demands are important conditions for healthcare professionals’ engagement in organizational improvement work. To develop social capital, leadership quality is an important precondition. Social capital can be regarded as a resource for sustainable organizational improvement work in healthcare, because of its importance for healthcare professionals’ engagement, job satisfaction, and intention to leave.

  • 9.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health promoting leadership – a structure to build capacity for health in a healthcare organization2014Conference paper (Refereed)
  • 10.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701).
    Hälsofrämjande arbetsmiljö–en framgångsfaktor för god vård2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 2, p. 175-188Article, review/survey (Refereed)
    Abstract [en]

    Work environment issues in health care have importance not only for employees but also for patients. The aim of this article is to describe important conditions for a health-promoting work environment, the significance of this for health care service, and how health-promoting work conditions can be developed. The results from our, as well as from others’, previous research show that employees’ work environment, health and engagement are critical for the improvements of quality of care and patient safety. Important factors are social capital (i.e. recognition, reciprocity and trust between humans), as well as practice-oriented approaches to developments based in system theory perspectives. The social capital can be compared to the fuel in a cycle creating work satisfaction, engagement and new ways of working and a practice-oriented and a servant leadership facilitates the development and the sustainability of this cycle.

  • 11.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH).
    Ahlstrom, Linda
    Högskolan i Borås, Sweden.
    Bergman, David
    Karolinska Institutet, Sweden.
    Dellve, Lotta
    KTH, School of Technology and Health (STH).
    The importance of Leadership for social capital among healthcare professionals2015Conference paper (Refereed)
    Abstract [en]

    Introduction

    Social capital, operationalized as perceived trust, reciprocity and recognition has in earlier research shown to be important for employees´ job satisfaction and to health care staffs´ engagement in clinical improvements of patient safety and quality of care as well as job satisfaction, health and wellbeing. Since social capital has an impact, it is of interest to investigate which factors that influence workplace social capital. Research findings shows that leadership has great importance to staffs´ health and wellbeing, and affects a number of factors in the work environment factors as job satisfaction and work engagement. If and how leadership is associated with social capital is rarely described in previous research. However the few studies performed indicate that there are associated correlations between leadership and social capital, and leadership quality and social capital. Leadership within healthcare sector has been in focus when working with redesign of care processes and it would be of interest to investigate the role of leadership and the quality of leadership with respect to social capital. The aim was to assess the importance of leadership for workplace social capital in hospital settings.

     

    Materials and methods

    This study was a longitudinal cohort study. Questionnaires to physicians, nurses, assistant nurses at five Swedish midsize hospitals was used to collect data (T0, n=865, T1, n=908). Bivariate, multivariate analyses was used and a mixed model repeated measurement for the longitudinal analyses (n=477) were performed.

     

    Results

    Relationship between staffs perceived quality of leadership and staffs´ social capital was found (R = 0.58, p-value <0.0001). Results of the analysis showed significant differences in levels of social capital between the groups of low, medium and high levels in quality of leadership. The differences between the groups sustained over time where the group with high levels in quality of leadership remained higher in levels of social capital than the other groups. Same pattern were seen in the other groups.

     

    Conclusion

    Leadership quality were related to-, had importance for- and influenced workplace social capital among health care staff.

  • 12.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Ahlstrom, Linda
    Bergman, David Kristofer
    Dellve, Lotta
    Leadership quality: a factor important for social capital in healthcare organizations2017In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 31, no 2, p. 175-191Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to investigate the relation between leadership and social capital and what qualities of leadership are important for social capital among employees in hospital settings over time. Design/methodology/approach - A cohort of employees in hospitals answered a questionnaire at three occasions. Five small (approx. 100-bed) or mid-sized (approx. 500-bed) hospitals were included. The response rate was 54 percent at baseline (n = 865), 59 percent at one-year follow-up (n = 908) and 67 percent at two-year follow-up (n = 632). Findings - Repeated measures over time showed differences between groups in levels of social capital with respect to levels of leadership quality. Relation-oriented leadership had the strongest association with social capital. There was evidence that leadership was associated with social capital over time and that different kinds of leadership qualities were associated with social capital. Research limitations/implications - This study conducted and analyzed quantitative data, and therefore, there is no knowledge of managers' or employees' own perceptions in this study. However, it would be interesting to compare managers' decreased and increased leadership quality and how such differences affect social capital over time. Practical implications - The findings feature the possibility for healthcare leaders to build high quality leadership as an important resource for social capital, by using different leadership orientations under different circumstances. Originality/value - The paper showed that leadership was an important factor for building social capital and that different leadership qualities have different importance with respect to certain circumstances.

  • 13.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Bergman, David
    Karolinska Institutet, Sweden.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Social capital among healthcare professionals: A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements2016In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 53, p. 116-125Article in journal (Refereed)
    Abstract [en]

    Background: Social capital can be an important resource to facilitate the needed improvements in quality of care and efficiency in hospitals. Objectives: To assess the importance of social capital (recognition, vertical trust, horizontal trust and reciprocity) for job satisfaction, work engagement and engagement in clinical improvements. Design: A prospective cohort design was used. Settings: Intensive care units and emergency, surgical and medical units at five Swedish hospitals with ongoing development of their processes of care. Participants: Healthcare professionals (physicians, registered nurses, assistant nurses) at five Swedish midsize hospitals. Methods: The participants answered a questionnaire at two occasions, NN = 1602 at baseline and NN = 1548 at one-year follow-up. Mean hospital response rate was 53% at baseline and 59% at follow-up. Univariate, multivariate and logistic regression analyses were performed, and the prospective analysis was based on 477 respondents. Results: Social capital was associated with healthcare professionals' general work engagement and job satisfaction. Analysis showed positive associations between all measured aspects of social capital and engagement in clinical improvements of patient safety and quality of care. The prospective analysis showed that increased social capital predicted increased job satisfaction, work engagement and engagement in clinical improvements of patient safety. Conclusion: Social capital is strongly related to job satisfaction and active engagement with clinical improvements. The findings contribute to a deeper knowledge of social capital as a predictive factor that influences patient safety and health among healthcare staff.

  • 14.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Social capital and its associations to employees active work with clinical development and health2013Conference paper (Refereed)
  • 15.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH).
    Lotta, Dellve
    Eriksson, Andrea
    KTH, School of Technology and Health (STH).
    Hälsofrämjande arbetsmiljö–en framgångsfaktor för god vård2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 2, p. 177-185Article in journal (Refereed)
    Abstract [en]

    Work environment issues in health care have importance not only for employees but also for patients. The aim of this article is to describe important conditions for a health-promoting work environment, the significance of this for health care service, and how health-promoting work conditions can be developed. The results from our, as well as from others’, previous research show that employees’ work environment, health and engagement are critical for the improvements of quality of care and patient safety. Important factors are social capital (i.e. recognition, reciprocity and trust between humans), as well as practice-oriented approaches to developments based in system theory perspectives. The social capital can be compared to the fuel in a cycle creating work satisfaction, engagement and new ways of working and a practice-oriented and a servant leadership facilitates the development and the sustainability of this cycle.

1 - 15 of 15
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