Gudbjörg Erlingsdóttir - Academia.edu (original) (raw)

Papers by Gudbjörg Erlingsdóttir

Studier visar att när nya styrmodeller införs i olika verksamheter blir resultatet inte alltid de... more Studier visar att när nya styrmodeller införs i olika verksamheter blir resultatet inte alltid det planerade. Spridningsprocessen av en ny modell eller idé kan i de flesta fall snarare beskrivas som svårkontrollerbar där både modellerna och deras syfte blir omtolkade på vägen. I kapitlet används införandet av två idéer om styrning, kvalitetssäkring av hälso- och sjukvården och ackreditering av laboratorier, för att illustrera två helt olika spridningsprocesser inom hälso- och sjukvården. Genom att studera hur idéerna tolkas i tid och rum under spridningsprocessen, skapas förståelse för och insikt i de faktorer som gör att vissa styrmodeller får avsedd effekt medan andra får helt andra effekter än de planerade eller inga alls.

The aim of the study on which the paper is based (see Erlingsdóttir, 1999) was to expand our unde... more The aim of the study on which the paper is based (see Erlingsdóttir, 1999) was to expand our understanding of the processes of institutionalisation both within and between organisational fields. This was done by tracing an idea – the idea of quality assurance – through the process of institutionalisation in the health care sector. Quality assurance is deliberately described in terms of an idea to emphasize that the object of study was not one technique, one model or one definition. On the contrary, the intent with the study was to find out how those who have created and used the idea of quality assurance have interpreted it during the process of institutionalisation.

Flertalet studier av hur innovationer sprids och hur makt utövas präglas av ett diffusionsperspek... more Flertalet studier av hur innovationer sprids och hur makt utövas präglas av ett diffusionsperspektiv (se exempelvis Brown, 1981). Sådana processer beskrivs då ofta som kausala kedjor av händelser där avvikelser från vad man vill uppnå uppfattas som motstånd och hinder. Genom att organisationer anammar lösningar som bygger på samma ideal kan det leda till att de liknar varandra. Flera skandinaviska studier visar emellertid att en och samma idé kan tolkas väldigt olika när den omsätts i handling av lokala aktörer (tex Blomquist, 1996; Erlingsdottir, 1999). Ett alternativt synsätt är att studera de översättningar som görs i praktiken när tex en idé sprids (Latour, 1998). På så sätt kan hur en idé får olika form och betydelse studeras.

This paper describes and discusses how shared leadership, between two ward managers, was used as ... more This paper describes and discusses how shared leadership, between two ward managers, was used as one means to implement the changes brought about by a radical reorganization in a primary care clinic in South of Sweden (Erlingsdóttir, 2010a). The focus is thus on shared leadership, in combination with implementation of change discussing if and in such case how shared leadership can be used as a means to facilitate the face of implementation

We note that today ideas and models regarding both how to perform activities and how to present o... more We note that today ideas and models regarding both how to perform activities and how to present oneself are generously offered to all organisations. Thus ideas concerning organisational models, management principles and quality assurance travel between countries, fields and organisations (Czarniawska and Sevòn, 1996). Organisations in the public sector, faced with the demand for higher productivity and customisation with reduced resources, will often find solutions to their problems in ideas circulating in their particular organisation field (DiMaggio, 1983; Jacobsson, 1995). In this project, one such idea is studied; the idea of health care quality assurance. The aim of the project is to build a theoretical frame for the analysis of how ideas are created and transmitted through the organisation field, and what happens when they meet the practice at hand in the organisation in which they are implemented. This will be done by joining parts of the so-called new institutional theory (

BMC Health Services Research

Background eHealth applications are considered a technological fix that can potentially address s... more Background eHealth applications are considered a technological fix that can potentially address some of the grand challenges in healthcare, including burnout among healthcare professionals, the growing burden of patients with chronic conditions, and retaining and recruiting healthcare professionals. However, as the deployment of eHealth applications in healthcare is relatively novel, there is a lack of research on how they affect the work environment of healthcare professionals. This study explores how work evolves—particularly for nurses—during the utilisation of three eHealth applications. Methods The study is a qualitative case study with an interpretive approach. The utilisation of three different eHealth applications was studied. Seventy-five healthcare professionals were interviewed, most of whom were nurses (n = 47). Interviews were transcribed verbatim and qualitative content analysis was used to analyse the text. Results Three main themes were identified: work that is ignor...

Health & Social Care in the Community

JMIR Formative Research, 2022

Background Traditional primary care is characterized by patient consultations via phone and physi... more Background Traditional primary care is characterized by patient consultations via phone and physical visits. However, the current development in Swedish primary care is to blend digital solutions with traditional solutions. This paper addresses this development by examining the normalization of embedding and integrating a digital health care platform into everyday care routines in a primary care clinic. The digital health care platform enables both synchronous (video calls) and asynchronous (chat) communication, as well as self-registration of patient data using automated questions and forms requiring the patient’s input. Objective This study aims to explore the work that health care professionals (HCPs) have to undertake to implement and sustain a digital health care platform as part of their everyday work practice. Methods HCPs were observed and interviewed to assess their individual and collective engagement and the mechanisms involved in the implementation of the digital platfor...

BACKGROUND The literature on how to communicate reform in organizations has mainly focused on lev... more BACKGROUND The literature on how to communicate reform in organizations has mainly focused on levels of hierarchy and has largely ignored the variety of professions that may be found within an organization. In this study, we focus on the relationship between media type and professional responses. OBJECTIVE The objective of this study was to investigate whether and how belonging to a profession influences the choice of communication media and the perception of information when a technical innovation is implemented in a health care setting. METHODS This study followed a mixed methods design based on observations and participant studies, as well as a survey of professionals in psychiatric health care in Sweden. The χ2 test was used to detect differences in perceptions between professional groups. RESULTS The use of available communication media differed among professions. These differences seem to be related to the status attached to each profession. The sense-making of the information...

The amount of care provided in the home will grow significantly as care transforms to meet the ch... more The amount of care provided in the home will grow significantly as care transforms to meet the challenges of an aging population. When care services move into the home, this environment becomes a workplace for a number of professionals, while still being a home for the care recipient. Much equipment and material is needed in the care situation and tends to turn parts of the home into a hospital. In an ongoing research project with home care organizations in Sweden, we are examining the need for improvements in the physical environment in home care and generating solutions to meet these needs. The solutions need to be functional for the home care workers and at the same time be attractive and preserve a homelike atmosphere. We have observed how issues related to hygiene, working surfaces, disposable materials, and lighting can result in nonergonomic work postures, eye strain, and other risks for the practitioner and the care recipient. Emanating from these issues, university students...

Using the metaphores of Haute Couture and Pret a porter we would like to examine some of the fash... more Using the metaphores of Haute Couture and Pret a porter we would like to examine some of the fashions that have been spread in the Swedish health care sector the past two decades. Who are the fashion makers? Who dicides what to import and why? Who are the models demonstrating the last fashion? most of all we wonder if the Haute Couture gets transformd into Pret a Porter so that it suites and becomes useful to the broad masses. And if not what do people do with fashion?

In 2015 Region Skane was the first county council in Sweden to add adult psychiatry patients to t... more In 2015 Region Skane was the first county council in Sweden to add adult psychiatry patients to the civic service of patient online access to their EHR (electronic health records). The initial implementation of the service in somatic care had previously raised both questions and resistance amongst the healthcare professionals. It was thus considered important to inform the professionals involved about the planned introduction in psychiatry well in advance. This paper presents and discusses how well the management was able to do this. The material presented derives from a survey that was distributed to employees in adult psychiatry in Region Skane just before the introduction of the service. Overall, the results show that different professions receive information through different channels. This indicates that it is important for an employer to use many information and communication channels to reach employees. It is also important to use both interpersonal and mediated communication...

General rights Unless other specific re-use rights are stated the following general rights apply:... more General rights Unless other specific re-use rights are stated the following general rights apply: Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal

Journal of Interprofessional Care, 2018

The concept of teamwork has been associated with improved patient safety, more effective care and... more The concept of teamwork has been associated with improved patient safety, more effective care and a better work environment. However, the academic literature on teamwork is pluralistic, and there are reports on discrepancies between theory and practice. Furthermore, healthcare professionals' direct conceptualizations of teamwork are sometimes missing in the research. In this study, we examine doctors' conceptualizations of teamwork. We also investigate what doctors think is important in order to achieve good teamwork, and how the empirical findings relate to theory. Finally, we discuss the methodological implications for future studies. The research design was explorative. The main data consisted of semi-structured interviews with twenty clinically active doctors, analyzed with conventional content analysis. Additional data sources included field observations and interviews with management staff. There was large variation in the doctors' conceptualizations of teamwork. The only characteristic they shared in common was that team members should have specific roles. This could have consequences for practice, because the rationale behind different behaviors depends on how teamwork is conceptualized. Several of the teamwork-enabling factors identified concerned non-technical skills. Future studies should put more emphasis on the practitioners' perspective in the research design, to create a more grounded foundation for both research and practice.

Journal of Medical Internet Research, 2019

BackgroundThe New Public Management movement strove for transparency so that policy makers and ci... more BackgroundThe New Public Management movement strove for transparency so that policy makers and citizens could gain insight into the work and performance of health care. As the use of the electronic health record (EHR) started to diffuse, a foundation was laid for enhanced transparency within and between health care organizations. Now we appear to be experiencing a new kind of transparency in the health care sector. Many health care providers offer their patients online access to their EHRs (here referred to as Open Notes). The Open Notes system enables and strives for transparency between the health care organization and the patient. Hence, this study investigates health care professional (HCP) perceptions of Open Notes and deepens the understanding of the transparency that Open Notes implies.ObjectiveBased on two survey studies of HCP perceptions of Open Notes, this paper aims to deepen the academic writing on the type of transparency that is connected to Open Notes.MethodsHCPs in ...

JMIR Mental Health, 2018

Background When the Swedish version of Open Notes, an electronic health record (EHR) service that... more Background When the Swedish version of Open Notes, an electronic health record (EHR) service that allows patients online access, was introduced in hospitals, primary care, and specialized care in 2012, psychiatric care was exempt. This was because psychiatric notes were considered too sensitive for patient access. However, as the first region in Sweden, Region Skåne added adult psychiatry to its Open Notes service in 2015. This made it possible to carry out a unique baseline study to investigate how different health care professionals (HCPs) in adult psychiatric care in the region expect Open Notes to impact their patients and their practice. This is the first of two papers about the implementation of Open Notes in adult psychiatric care in Region Skåne. Objective The objective of this study was to describe, compare, and discuss how different HCPs in adult psychiatric care in Region Skåne expect Open Notes to impact their patients and their own practice. Methods A full population We...

How does esociety affect healthcare practice?

In Swedish health care various effects of NPM have been observed. These include downsizing, struc... more In Swedish health care various effects of NPM have been observed. These include downsizing, structural transformation and new management reforms, which have been successively tried out one after the other, in the attempt to make work and organizations more effective, efficient and easily controlled. An important aspect of these changes is their encounter with, and effect on, existing forms of control, for instance the autonomy of the medical profession. Traditionally, doctors themselves have had full control over the division, organization and performance of their work, as well as scrutinizing each other and defining quality (Abbot, 1991; Friedson, 1994). Ideology, in terms of morals, ethics and values is another important aspect of doctors' professionalism, which has historically been based on medical and humanitarian foundations. However, the state and doctors have long been mutually dependent in defining the scope of the profession in terms of legitimacy and working area (Dent, 1995; Ferlie, Ashburner, Fitzgerald and Pettigrew, 1996; Friedson, 2001). Whether or not the limits of doctors' autonomy and self-assessment are being renegotiated and redefined by the introduction of NPM, has been discussed by a number of authors (see, for instance, Dent, 1995; Kraigh-Jesperson, 1999; Broadbent and Laughlin, 2002). The effects of NPM may vary substantially between countries and might be less radical in the Nordic countries than in Great Britain (Pollitt, 2002). In this paper, the effects of NPM on the professionalism of the medical profession in Sweden are described and discussed through a historical comparison. As the basis for the comparison before and after NPM, I use Friedson's (2001) ideal type for professionalism. According to the ideal type a number of criteria have to be fulfilled in order for an occupation to be defined as being professional. The criteria or elements of the ideal type primarily deal with the extent to which an occupation can negotiate or claim a unique