The Role of Chief Medical officers in making Public Health Overview Documents in Norwegian Municipalities. A qualitative Study.

Aims: To investigate how Chief Medical Officers experience their role in the municipalities´ work with making the public health overview documents, demanded by the Norwegian Public Health Act from 2012.

Methods: A qualitative study with semi-structured focus group interviews with 21 Chief Medical Officers from 20 different municipalities in Norway. The interviews were conducted in 2017.

General practitioners' experiences of being involved in local public health work in Norway. A qualitative study.

Aim: The aim was to explore how general practitioners experienced being involved in local public health work and how they worked with prevention and health promotion clinically after the introduction of the Public Health Act in 2012.

Design, Setting And Subjects: Qualitative study with focus groups interviews with 18 GPs from different municipalities in Norway.

Results: The GPs said that they either had not at all or only to a limited extent been involved in local public health work in their municipalities.

Disease-specific clinical pathways - are they feasible in primary care? A mixed-methods study.

Objective: To explore the feasibility of disease-specific clinical pathways when used in primary care.

Design: A mixed-method sequential exploratory design was used. First, merging and exploring quality interview data across two cases of collaboration between the specialist care and primary care on the introduction of clinical pathways for four selected chronic diseases.

Generic care pathway for elderly patients in need of home care services after discharge from hospital: a cluster randomised controlled trial.

Background: Improved discharge arrangements and targeted post-discharge follow-up can reduce the risk of adverse events after hospital discharge for elderly patients. Although more care is to shift from specialist to primary care, there are few studies on post-discharge interventions run by primary care. A generic care pathway, Patient Trajectory for Home-dwelling elders (PaTH) including discharge arrangements and follow-up by primary care, was developed and introduced in Central Norway Region in 2009, applying checklists at defined stages in the patient trajectory.

Integrated care services: lessons learned from the deployment of the NEXES project.

Objectives: To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus.

Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care.

Background: In Central Norway a generic care pathway was developed in collaboration between general hospitals and primary care with the intention of implementing it into everyday practice. The care pathway targeted elderly patients who were in need of home care services after discharge from hospital. The aim of the present study was to investigate the implementation process of the care pathway by comparing the experiences of health care professionals and managers in home care services between the participating municipalities.

Predictors for assessing electronic messaging between nurses and general practitioners as a useful tool for communication in home health care services: a cross-sectional study.

Background: Nurses providing home health care services are dependent on access to patient information and communicating with general practitioners (GPs) to deliver safe and effective health care to patients. Information and communication technology (ICT) systems are viewed as powerful tools for this purpose. In Norway, a standardized electronic messaging (e-messaging) system is currently being established in health care.

Home care nurses' experiences with using electronic messaging in their communication with general practitioners.

Aims And Objectives: To investigate the experiences of home care nurses with electronic messaging (e-messaging) and to determine how it influenced their communication with general practitioners.

Background: Nurses in home care services must collaborate with general practitioners to care for homebound patients. Studies have shown that communication and collaboration are often constrained because they are organised separately and are dispersed.

A collaborative chain out of phase.

Introduction: The aim of this study is to explore the obstacles to collaborations between nurses in hospital and municipal care in the discharge of hospital patients who need continuing care.

Methods: First, we conducted in-depth interviews of nurses in hospitals and nurses in municipal care. Second, we developed questionnaires and distributed them to a representative sample of Norwegian municipalities to study the representativeness of the most important findings from the interviews.

Development of a patient-centred care pathway across healthcare providers: a qualitative study.

Background: Different models for care pathways involving both specialist and primary care have been developed to ensure adequate follow-up after discharge. These care pathways have mainly been developed and run by specialist care and have been disease-based. In this study, primary care providers took the initiative to develop a model for integrated care pathways across care levels for older patients in need of home care services after discharge.

Avoidable emergency admissions?

Background: Use of specialist healthcare services is increasing.

Aim: To evaluate whether alternative healthcare services could reduce the need for admissions to specialist care hospitals.

Design: Prospective observational study of emergency referrals for admission to specialist care.

GPs' prescription routines and cooperation with other healthcare personnel before and after implementation of multidose drug dispensing.

Background: This study addresses GPs' attitudes towards multidose drug dispensing before and after implementation and their perceived experience of how multidose drug dispensing affects prescription and communication routines for patients in the home care services. This study contributes to a method triangulation with two other studies on the introduction of multidose drug dispensing in Trondheim.

Methods: A controlled before-and-after study carried out in Trondheim (intervention) and Tromsø (control).

Psychoactive drugs in seven nursing homes.

Aims: We wanted to pinpoint any differences in treatment between participating nursing homes, investigate which drugs are currently prescribed most frequently for long-term patients in nursing homes, estimate prevalence of administration for the following drug groups: neuroleptics, antidepressants, antidementia agents, opioids and the neuroleptics/anti-Parkinson's drug combination, and study comorbidity correlations. We also wanted to study differences in the administration of medications to patients with reduced cognitive functions in relation to those with normal cognition.

Methods: Information about 513 patients was collected from seven nursing homes in the city of Bergen, Norway, during the period March-April 2008.

High sensitivity measurements of active oxysterols with automated filtration/filter backflush-solid phase extraction-liquid chromatography-mass spectrometry.

Oxysterols are important in numerous biological processes, including cell signaling. Here we present an automated filtration/filter backflush-solid phase extraction-liquid chromatography-tandem mass spectrometry (AFFL-SPE-LC-MS/MS) method for determining 24-hydroxysterol and the isomers 25-hydroxycholesterol and 22S-hydroxycholesterol that enables simplified sample preparation, high sensitivity (~25 pg/mL cell lysis sample) and low sample variability. Only one sample transfer step was required for the entire process of cell lysis, derivatization and determination of selected oxysterols.

Assessment of left ventricular function by GPs using pocket-sized ultrasound.

Background: Assessment of left ventricular (LV) function with echocardiography is mandatory in patients with suspected heart failure (HF).

Objectives: To investigate if GPs were able to evaluate the LV function in patients at risk of developing or with established HF by using pocket-sized ultrasound (pUS).

Methods: Feasibility study in general practice, seven GPs in three different Norwegian primary care centres participated.

Can electronic tools help improve nursing home quality?

Background. Nursing homes face challenges in the coming years due to the increased number of elderly. Quality will be under pressure, expectations of the services will rise, and clinical complexity will grow.

Hospital admissions from nursing homes: rates and reasons.

Hospital admissions from nursing homes have not previously been investigated in Norway. During 12 months all hospital admissions (acute and elective) from 32 nursing homes in Bergen were recorded via the Norwegian ambulance register. The principal diagnosis made during the stay, length of stay, and the ward were sourced from the hospital's data register and data were merged.

Closing information gaps with shared electronic patient summaries: how much will it matter?

Background: Information deficits contribute to medical errors. Hence several efforts to develop electronic communication systems to facilitate a flow of information between health care providers have been attempted, including initiatives to develop regional or national electronic patient summaries.

Objectives: To study information access and information needs in inpatient emergency departments, and how clinicians in these departments handle deficits in available information.

Healthcare professionals' experiences with EHR-system access control mechanisms.

Access control mechanisms might influence on the information seeking and documentation behavior of clinicians. In this study, we have surveyed healthcare professionals in nursing homes and hospitals on their attitudes to, and experiences with using access control mechanisms. In some situations, the access control mechanisms of the EHR system made clinicians postpone documentation work.

Integrated care in Norway: the state of affairs years after regulation by law.

Introduction: A mandatory multidisciplinary plan for individual care, the 'Individual care Plan', was introduced by law in Norway in 2001. The regulation was established to meet the need for improved efficiency and quality of health and social services, and to increase patient involvement. The plan was intended for patients with long-term and complex needs for coordinated care.

Early experiences with the multidose drug dispensing system--a matter of trust?

Objective: To study early experiences with multidose drug dispensing (MDD) among different groups of health personnel.

Design: Qualitative study based on focus-group interviews.

Setting: Primary health care, Trondheim, Norway.

Diffusion and use of Electronic Health Record systems in Norway.

This paper sums up some of the findings from a national survey on the diffusion and use of Electronic Health Record (EHR) systems in the Norwegian health sector. The survey shows that almost all hospitals and GPs use their EHR systems on a daily basis, while the municipalities are lagging behind, All three view costs and missing functionality as the most important challenges. The GPs are very concerned with the complexity of the daily operation of the systems, while the hospitals are mostly concerned with costs of daily operations, maintenance and further development of the systems.