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  • 1.
    Boström, Jonas
    et al.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics. Landstinget Västernorrland, Sundsvall.
    Hillborg, Helene
    Landstinget Västernorrland, Sundsvall.
    Lilja, Johan
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    Cultural Change of Applying User Involvement for Improving Healthcare Quality: A Review of the Impact on Attitudes, Values and Assumptions among Healthcare Professionals and Users2017In: Quality Innovation Prosperity, ISSN 1335-1745, E-ISSN 1338-984X, Vol. 21, no 3, p. 158-172Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study is to provide a review of the impact on culture (attitudes, values and assumptions) among both healthcare professionals, as well as users, when involving users for improving quality in healthcare.

    Methodology/Approach: The paper is based on an extensive, narrative literature review considering studies that included professional’s and users experiences of user involvement in quality improvement. The included articles were analyzed using an interpretive, along with a deductive, approach according to a theoretical framework.

    Findings: The results indicate that there is currently limited research focusing on the impact of user involvement in quality improvement processes regarding professionals’ and users’ attitudes, values and/or assumptions. The articles identified during the study provides situations and statements, during the process of development, which can be interpreted as change in the culture. Although few articles specifically draw conclusions on user involvement as a “tool” for cultural change, the authors interpret several findings which strengthens that theory.

    Research Limitation/implication: Research published in other databases could have been missed. The authors have tried to avoid this by using a snowball method reading references in identified articles.

    Originality/Value of paper: The review provides a platform for both future research and the development of current practice within the area. There have been literature reviews showing obstacles and enablers when using patients, users and relatives in quality improvement work, but few which investigates cultural change.

  • 2.
    Boström, Jonas
    et al.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    Hillborg, Helene
    Region Västernorrland.
    Lilja, Johan
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Management and Mechanical Engineering.
    Cultural Impact of Applying User Involvement  for Improving Healthcare Quality: A review of the impact on attitudes, values and assumptions among healthcare professionals and users2016In: Proceedings of the 19th QMOD Conference: Building a Culture for Quality, Innovation and Sustainability, 2016Conference paper (Refereed)
    Abstract [en]

    Purpose

    The purpose of this study is to provide a review of the impact on culture (attitudes, values and assumptions) among both healthcare professionals, as well as users, when involving users for improving quality in healthcare.

    Method

    The paper is based on an extensive, narrative literature review, covering 3786 papers.

    Findings

    The results indicate that there is currently limited research focusing on the impact of user involvement in quality improvement processes regarding professionals’ and users´ attitudes, values and/or assumptions. The articles identified during the study mentions situations and things which are said, during the process of development, and which can be interpreted as change in the culture. Although few articles specifically draw conclusions on user involvement as a “tool” for cultural change, the authors interpret several findings which strengthens that theory.

    Research limitations

    Research published in other databases could have been missed. The authors have tried to avoid this by using a snowball method reading references in identified articles.

    Practical implications

    Future research is needed to see if involvement activities in quality improvement processes can affect attitudes, values and assumptions in a positive way.

    Originality

    The review provides a platform for both future research and the development of current practice within the area. There has been literature reviews showing obstacles and enablers when using patients, users and relatives in quality improvement work, but few which investigates cultural change.

  • 3.
    Boström, Jonas
    et al.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Management and Mechanical Engineering.
    Hillborg, Helene
    Region Västernorrland.
    Lilja, Johan
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Management and Mechanical Engineering.
    Exploring Cultural Dynamics and Tensions when Applying Design Thinking for Improving Healthcare Quality: What is really going on?2018In: Proceedings of the 21th QMOD Conference: Building a Culture for Quality, Innovation and Sustainability / [ed] Su Mi Park-Daahlgard, 2018Conference paper (Refereed)
    Abstract [en]

    Purpose:

    The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking for improving quality in a healthcare setting.

    Method:

    The paper is based on a case study following a quality improvement project (QI) in a medium sized Swedish county council in the field of somatic care. The project involved eight healthcare professionals, one designer, four patients and two relatives. A multiple data collection method over a period of 10 months was used. It included individual interviews, e-mail correspondence and observations of workshops that covered the QI project.

    Findings:

    The result shows tensions between QI work and the daily clinical work of the participants. These tensions primarily concern the conflict between fast and slow processes, the problem of moving between different fields of knowledge, being a resource for the individual clinic and the system, and the participants' expectations and assumptions about roles and responsibilities in a QI project. Furthermore these findings could be interpreted as signs of a development culture in the healthcare context.

    Practical Implications:

    There are several practical implications. Among others, the insights can inspire how to approach and contextualize the current concepts, roles and methods of design thinking and user involvement so that they can be more easily understood and integrated into the existing culture and way of working in the healthcare sector.

    Originality:

    The study provides a unique insight into a case, trying to uncover what actually is going on, and perhaps why certain things are not happening at all, when user involvement and design practices are applied for improving healthcare quality.

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