Exploring a process-oriented way of working - a case study involving primary and specialised care.

Background: Health care organisations have a long history of dividing work and tasks into decentralised functions and units by forming divisions and departments with delegated power. New ways of working, such as process-oriented approaches, have been called for to address challenges such as staffing shortages and resource constraints. There is limited understanding of the interplays that will occur in health care organisations during a shift from a traditional decentralised structure to a process-oriented approach.

[Results of recent patient safety work in the surgical disciplines].

Swedish surgical care shows high quality and patient safety. The reasons for this are several; among the most important are a generally well-educated staff and nation-wide quality registers. Areas in need of development are improved risk assessment and risk management, both for individual patients and for specific types of operations.

Workplace interventions focusing on how to plan, organize and design the work environment in hospital settings: A systematic review.

Background: Occupational Health Service (OHS) is a service that should support employers and employees with their work environment. Previous research indicates the need for deeper knowledge about the effect of workplace interventions with a focus on planning, organizing and designing the workplace to improve work conditions in hospital settings.

Objective: The aim was to evaluate the outcomes, workplace interventions and intervention strategies in hospital settings.

Older Persons' and Health Care Professionals' Design Choices When Co-Designing a Medication Plan Aiming to Promote Patient Safety: Case Study.

Background: Harm from medications is a major patient safety challenge among older persons. Adverse drug events tend to arise when prescribing or evaluating medications; therefore, interventions targeting these may promote patient safety. Guidelines highlight the value of a joint plan for continued treatment.

How Older Persons and Health Care Professionals Co-designed a Medication Plan Prototype Remotely to Promote Patient Safety: Case Study.

Background: Harm from medications is a major patient safety challenge. Most adverse drug events arise when a medication is prescribed or reevaluated. Therefore, interventions in this area may improve patient safety.

Experience of learning from everyday work in daily safety huddles-a multi-method study.

Background: To reduce patient harm, healthcare has focused on improvement based on learning from errors and adverse events (Safety-I). Daily huddles with staff are used to support incident reporting and learning in healthcare. It is proposed that learning for improvement should also be based on situations where work goes well (Safety-II); daily safety huddles should also reflect this approach.

Evaluating the Effect of Supported Systematic Work Environment Management During the COVID-19 Pandemic: Protocol for a Mixed Methods Study.

Background: The work environment is a complex phenomenon in which many factors interact. Scientific research indicates a relation between the work environment and employee health, staff turnover, patient satisfaction, and patient safety. There is a great need for knowledge on how to conduct work environment interventions and practical work environment management to maximize benefits to the employees.

Preconditions for nurses' perceived organizational support in healthcare: a qualitative explorative study.

Purpose: The purpose of this paper is to inductively explore the context-specific preconditions for nurses' perceived organizational support (POS) in healthcare organizations.

Design/methodology/approach: A qualitative interview study was performed, based on the critical incident technique (CIT), with 24 registered nurses in different specialities of hospital care.

Findings: The nurses perceived three actors as essential for their POS: the first-line manager, the overarching organization and their college.

Sustainment of a patient flow intervention in an intensive care unit in a regional hospital in Australia: a mixed-method, 5-year follow-up study.

Objective: In 2014, an escalation plan and morning handover meetings were implemented in an intensive care unit (ICU) to reduce access block for post-operative care. In this study, the improvement intervention is revisited 5 years on with the objective to see if the changes are sustained and to understand factors contributing to sustainability.

Design: A mixed-method approach was used, with quantitative analysis of ICU administrative data and qualitative analysis of interviews with hospital management and ICU staff.

Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions.

Background: Older persons with polypharmacy are at increased risk of harm from medications. Therefore, it is important that physicians and nurses, together with the persons, evaluate medications to avoid hazardous polypharmacy. It remains unclear how healthcare professionals experience such evaluations.

Health care workers' experiences of workplace incidents that posed a risk of patient and worker injury: a critical incident technique analysis.

Background: Health care workers (HCWs) are at high risk of occupational injuries and approximately 10-15% of patients are affected by an adverse event during their hospital stay. There is scarce scientific literature about how HCWs manage these risks in practice and what support they need. This knowledge is needed to improve safety for patients and HCWs.

[Patient safety in real time at covid-19 units in Region Jönköping County].

The adaptation of the healthcare needed in the covid-19 pandemic poses challenges to patient safety. Proactive patient safety work must continue even under conditions such as a pandemic. Methods are needed that assess and support patient safety as the work is carried out.

Improvement work in mental healthcare: an example from Region Jönköping County, Sweden.

Region Jönköping County (RJC) in Sweden is a healthcare system that is characterised by sustainable work with quality in healthcare and long-term system-wide improvement. This article describes important factors behind the improvement work in RJC, and how the improvement methods and initiatives have been adopted also in mental healthcare. For example, patients otherwise eligible for admission to a psychiatric department were treated at home after introduction of home treatment teams.

[Patient safety work has to develop and intensify].

Knowledge about safety in complex systems are growing and health care is a complex system that is both developing and under pressure. Therefore, patient safety work also has to develop. Basic conditions for safe performance are important: management that values safety, good working conditions, safety culture, adequate staffing and competence, and equipment that facilitates safe practice.

[Two nosocomial outbreaks of group A streptococcal puerperal sepsis].

Two minor outbreaks of puerperal sepsis in two different hospitals are presented. In four (out of totally five) cases nosocomial transmission of group A streptococci (GAS) from health care workers to patients was likely to have occurred, based on epidemiological links and microbiological typing results. This is a reminder of the importance of careful adherence to standard precautions, but also illustrates the difficulties in keeping up good results over time.

Older persons' experiences regarding evaluation of their medication treatment-An interview study in Sweden.

Background: Older persons with polypharmacy are at increased risk of harm from medications, and this issue is a global patient safety challenge. Harm may arise at all stages of medication use and may cause hospital admission, additional resource utilization and lower patient satisfaction. Older persons' participation in their own care may increase patient safety.

Are Incidental Gallbladder Cancers Missed with a Selective Approach of Gallbladder Histology at Cholecystectomy?

Background: Incidental gallbladder cancer (IGBC) is an unexpected finding when a cholecystectomy is performed upon a benign indication, and the use of routine or selective histological analysis of gallbladder specimen is still debated. The aim of this study was to investigate whether the proportion of submitted gallbladder specimens for pathological investigation influences the proportion of IGBC found, and what possible factors preoperatively or perioperatively could influence the selection process.

Methods: All cholecystectomies between January 2007 and September 2014 registered in the Swedish Registry of Gallstone Surgery and ERCP (GallRiks) were included.

Exploring patients' perceptions of accessing electronic health records: Innovation in healthcare.

The more widespread implementation of electronic health records has led to new ways of providing access to healthcare information, allowing patients to view their medical notes, test results, medicines and so on. In this article, we explore how patients perceive the possibility to access their electronic health record online and whether this influences patient involvement. The study includes interviews with nine patients and a survey answered by 56 patients.

[Patient safety require rules and procedures that are both followed and disregarded].

Modern health-care is a complex socio-technical system, and as such variability is normal and necessary. The ability of a complex system such as health-care to quickly and correctly adapt to varying circumstances is crucial to how well the system works. Both increased compliance to guidelines, and a concurrent ability in individuals to deviate from these guidelines in certain situations, can be expected to increase safety.

Non-randomised patients in a cholecystectomy trial: characteristics, procedures, and outcomes.

Background: Laparoscopic cholecystectomy is now considered the first option for gallbladder surgery. However, 20% to 30% of cholecystectomies are completed as open operations often on elderly and fragile patients. The external validity of randomised trials comparing mini-laparotomy cholecystectomy and laparoscopic cholecystectomy has not been studied.

Cholecystectomy: costs and health-related quality of life: a comparison of two techniques.

Background: Outcomes of previous health economic evaluations comparing minilaparotomy cholecystectomy and laparoscopic cholecystectomy have been inconsistent.

Objective: To compare costs for minilaparotomy cholecystectomy and laparoscopic cholecystectomy and to study changes in quality of life induced by these operations.

Design: Single-blind, randomized controlled trial, run from 1 March 1997 to 30 April 1999.