Bottom-up priority setting revised. A second evaluation of an institutional intervention in a Swedish health care organisation

Abstract There is a need for improved knowledge about how workplace conditions and organisational factors may obstruct or facilitate work in late life. By means of both quantitative and qualitative data, this study aims to explore retirement preferences among employees (aged 55 and older) in a large Swedish health-care organisation and to identify work-related motives influencing their retirement preferences. The quantitative analysis showed large variation in retirement preferences in the organisation. The qualitative results were summarised into two overarching types of motives for late and early retirement preferences, general and group-specific. The general motives were shared by the early and late preference groups, and included recognition, flexibility, health and work motivation. The group-specific motives were exclusively related to either an early or a late retirement preference. Criticism towards the organisation and strenuous working conditions were specific motives for an early retirement preference, while positive accounts of work and a wish to utilise one's own competencies as well as being financially dependent on work was stated as specific motives for wanting to retire late. The results illustrate the need to improve organisational practices and routines, as well as working conditions, in order to make an extended working life accessible for more than already-privileged groups of employees.

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The influence of social challenges when implementing information systems in a Swedish health-care organisation

Journal of Nursing Management ◽

10.1111/jonm.12383 ◽

2016 ◽

Vol 24 (6) ◽

pp. 789-797 ◽

Cited By ~ 4

Author(s):

Lina Nilsson ◽

Sara Eriksén ◽

Christel Borg

Keyword(s):

Health Care ◽

Information Systems ◽

Health Care Organisation ◽

Social Challenges ◽

Care Organisation ◽

Swedish Health Care

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The potential for inadvertent adverse consequences of open disclosure in Australia: when good intentions cause further harm

Medicine Science and the Law ◽

10.1177/0025802419872049 ◽

2019 ◽

Vol 59 (4) ◽

pp. 265-274 ◽

Cited By ~ 2

Author(s):

Alice Holmes ◽

Lyndal Bugeja ◽

David Ranson ◽

Debra Griffths ◽

Joseph Elias Ibrahim

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Legal Protection ◽

Care Providers ◽

Health Care Organisation ◽

Open Disclosure ◽

Care Organisation ◽

Family Expectations ◽

Training And Support

Open disclosure is a valuable process which has the potential to benefit both the patients who receive the open disclosure and the health care professionals (or organisations) who provide it. The benefits from open disclosure will most often be seen when open disclosure is performed in an ‘ideal’ manner. When open disclosure is suboptimal, it can lead to harmful consequences for patients and health care providers alike. Numerous factors may contribute to an inadequate open disclosure including: potentially inadequate legal protection for health care professionals or organisations; failing to meet patient and/or family expectations; health care professionals experiencing a lack of education, training and support from the health care organisation; or a fear of litigation. An inadequate open disclosure may result in inadvertent consequences including: patients/families who are dissatisfied; potentially preventable litigation; legal repercussions for health care professionals and organisations; and patient harm where open disclosure is not implemented. This article seeks to explore these barriers and considers how the implementation of open disclosure could be improved to overcome these barriers. Overcoming these barriers should help to reduce the risk of inadvertent consequences and lead to better outcomes for patients, health care professionals and health care organisations.

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Formal priority setting in health care: the Swedish experience

Journal of Health Organization and Management ◽

10.1108/jhom-09-2014-0150 ◽

2016 ◽

Vol 30 (6) ◽

pp. 891-907 ◽

Cited By ~ 3

Author(s):

Peter Garpenby ◽

Karin Bäckman

Keyword(s):

Health Care ◽

Priority Setting ◽

National Level ◽

Regional Health ◽

Bottom Up ◽

Content Type ◽

Political Conflicts ◽

Health Authorities ◽

Financial Pressure ◽

Regional Health Authorities

Purpose From the late 1980s and onwards health care in Sweden has come under increasing financial pressure, forcing policy makers to consider restrictions. The purpose of this paper is to review experiences and to establish lessons of formal priority setting in four Swedish regional health authorities during the period 2003-2012. Design/methodology/approach This paper draws on a variety of sources, and evidence is organised according to three broad aspects: design and implementation of models and processes, application of evidence and decision analysis tools and decision making and implementation of decisions. Findings The processes accounted for here have resulted in useful experiences concerning technical arrangements as well as political and public strategies. All four sites used a particular model for priority setting that combined top-down- and bottom-up-driven elements. Although the process was authorised from the top it was clearly bottom-up driven and the template followed a professional rationale. New meeting grounds were introduced between politicians and clinical leaders. Overall a limited group of stakeholders were involved. By defusing political conflicts the likelihood that clinical leaders would regard this undertaking as important increased. Originality/value One tendency today is to unburden regional authorities of the hard decisions by introducing arrangements at national level. This study suggests that regional health authorities, in spite of being politically governed organisations, have the potential to execute a formal priority-setting process. Still, to make priority-setting processes more robust to internal as well as external threat remains a challenge.

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Participative management in health care services

Curationis ◽

10.4102/curationis.v18i1.1347 ◽

1995 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

M. Muller

Keyword(s):

Health Care ◽

Health Care Services ◽

Care Delivery ◽

Inductive Reasoning ◽

Participative Management ◽

Management Approach ◽

Health Care Organisation ◽

Care Services ◽

Care Organisation ◽

Interactive Decision Making

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

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