Mid Sweden University

Purpose - The purpose of this paper is to present and analyse the result from using a questionnaire measuring the presence of a number of QM values, as well as the use of Appreciative Inquiry (AI) and the feeling of pride in a healthcare setting focusing on transitional care.

Methodology/approach – Co-workers at two different hospital’s intensive care units answered a previously developed and tested questionnaire. A new factor was developed in order to measure customer focus in the healthcare context. The result was analysed using SPSS with the aim of finding areas to improve the patient transfer process from intensive care to general ward.

Findings – The questionnaire can be used to create an understanding of the existing culture in an organization but it needs to be analysed qualitatively. The result from the examined organizations show a common culture in the two units even though they are located in different hospitals and cities. The result further shows some differences between professions but overall, the result points at a relatively high agreement to the QM values in the organization indicating the presence of a quality culture.    

Practical implications – Using a QM value survey in the healthcare context could help developing the care from a different point of view then ordinary. It could help to shift focus from individual to group and system.

Purpose

The purpose of this literature review was to explore to what extent quality management (QM) and nursing science offer complementary perspectives to provide better quality care, by looking at QM core concepts and tools.

Design/methodology/approach

A systematic literature review was conducted. Papers published in academic journals between January 2013 and December 2019 were included. A deductive content analysis was chosen using QM core values as an analytical framework.

Findings

The results showed that QM core values, methodologies and tools were found in the reviewed articles about intensive care unit (ICU) transitional care. The results indicated that core values in QM and the core competencies within nursing science in ICU transitional care are mutually dependent upon each other and exist as a whole. ICU transitional care is, however, a complex interpersonal process, characterized by differences in organizational cultures and core values and involving multidisciplinary teams that collaborate across hospital units. The QM core value that was least observed was committed leadership.

Research limitations/implications

Combining QM and nursing science can contribute to a deeper understanding of how to improve the ICU transitional care process by bringing complementary perspectives.

Practical implications

The included articles portray how QM is applied in ICU transitional care. Implications for future research focus on enhancing the understanding of how QM and nursing science can bring complementary perspectives in order to improve ICU transitional care and how QM values, methodologies and tools can be used in ICU transitional care. Committed leadership and team collaboration in ICU transitional care are areas that call for further research.

Originality/value

The findings contribute to the body of literature by providing important insights in terms of how QM core values, methodologies and tools are present in research about ICU transitional care and how the two research subjects, namely, QM and nursing science, bring complementary perspectives.

Purpose: Team collaboration is essential to ensure the quality of care and patient safety when critically ill patients are transferred from an intensive care unit (ICU) to a general ward. Measuring team collaboration in the patient transfer process can help gain insights into how team collaboration is perceived and how it can be improved. The purpose of this paper is to describe the development and testing of a questionnaire aiming to measure perceived team collaboration in the patient transfer process from ICU to the general ward. This study also aims to analyze the results to see how the survey could help improve team collaboration within ICU transitional care.

Design/methodology/approach: Statements, factors and main areas intended to measure perceived team collaboration were developed from a theory. The questionnaire was tested in two ICUs at two hospitals located in Sweden, and the results were analyzed statistically.

Findings: The results showed that the questionnaire could be used for measuring perceived team collaboration in this process. The results from the survey gave insights that can be useful when improving team collaboration in ICU transitional care.

Research limitations/implications: The collaboration between two research subjects, Nursing Science and Quality Management, has given new perspectives in how cultural and systemic differences and opportunities can help improving team collaboration in ICU transitional care, by shifting focus from the individual to team, culture, system, process and continuous improvement. Practical implications: The developed questionnaire can be used to measure perceived team collaboration and to identify areas for improving team collaboration in the ICU transitional care process.

Originality/value: There is a sparse amount of research about measuring team collaboration in ICU transitional care, and this study contributes to filling this research gap. 

Purpose: The purpose was twofold: first to describe how co-workers within a team perceived team collaboration in patient transfers from an intensive care unit (ICU) to general wards and, second, to describe co-workers’ suggestions for an improved future state of team collaboration.

Methodology/Approach: Focus group discussions (FGDs) were conducted at two medium-sized hospitals located in Sweden. Participants were multidisciplinary and from both ICUs and general wards. Data were analysed using qualitative deductive content analysis.

Findings: An expressed need for improving team collaboration was a defined and well-designed ICU transitional care process with a holistic view of how to create quality of care, and a standardised process for continuous improvements. This should involve co-workers from different professions and hospital units, as well as patients and relatives. Other views raised by the co-workers were clearer definitions of roles, responsibilities and deeper insights on how team members depend on each other’s work efforts to succeed.

Research Limitation/Implication: This study was conducted at two hospitals, hence no generalizable conclusions can be made.

Originality/Value of paper: Co-workers collaborating in a ICU transitional care process can have important insights in how to improve team collaboration. This can be of great importance in increasing quality of care where multiprofessional teams from different organisational cultures are collaborating.

Today, sustainable development and the Global Goals are a major concern for society and organizations. In order to become more sustainable, organizations need to develop their ways of working with Sustainable Quality Development (SQD). Sustainable Quality Management (SQM) and Sustainable Quality Culture (SQC) are important aspects for organizations in striving to become more sustainable and to create social, societal and environmental values. A Top Management Team (TMT) is a key resource for an organization’s sustainability and previous research show that characteristics of TMT manifest an organization’s strategic choices, outcomes and performance. TMT characteristic might therefore be one success factor in attaining performance. Studying success factors on how TMTs manage organizations towards SQD, and SQC can therefore be of great importance. Thus, the purpose of this paper was to explore research on how TMTs manage organizations towards SQD, focusing on success factors. Inclusion criteria for the review were; original research studies (peer-reviewed studies) describing characteristics and success factors for TMTs managing organizations towards SQD; literature published in English; and published between January 2010 and August 2021. Databases used for the searches were; Scopus, Web of Science and Business Source. Databases were searched on 15th of September 2021. A Content analysis inspired by affinity diagram was conducted in order to identify clusters of data representing success factors described in the 29 included articles. The thematic content analysis and clustering process ended up in five main categories of success factors. These main categories were; External factors, Leadership and management, Vision and goals, Individual and team characteristics and abilities, and Stability and dynamics. Some general insights from the conducted scoping review were, first that the included articles were mostly from Asia and from China. This indicates that further research is needed in other geographical continents and countries, in order to give a broader perspective on the specific topic. Secondly, the methodological approach in the reviewed articles was mostly quantitative which leads to a need for more qualitative approaches to get broader understanding of the area. Thirdly, that the meaning of SQD needs to be further elaborated since the TMT and the quality of its strategic decisions on sustainability are critical in achieving sustainable development. A conceptual discussion on SQD, SQM and SQC from a Quality Management lens can be implications for further research.

Purpose – The purpose was to present a developed, tested and evaluated methodology for assessingteamwork and sustainable quality culture, focusing on top management teams (TMTs).

Design/methodology/approach – The developed methodology was based on a convergent mixed-methoddesign, including two data collection methods: questionnaire and focus group discussion. Two pilot tests wereperformed with two TMTs. This design involved analysing, merging and interpreting data, first separately bydata collection method and theme and then in a meta-interpretation. Lastly, there was a follow-up meeting forevaluating results.

Findings – Findings from the study were that the methodology can be used to assess teamwork andsustainable quality culture, and the results also showed the strength of using two data collection methods toprovide a broader picture of teamwork and sustainable quality culture. A follow-up meeting validated theresults and provided additional value to the two TMTs in the form of suggestions on how to improve theirteamwork and sustainable quality culture.

Practical implications – Applying this methodology can guide TMTs in how to improve their teamworkand sustainable quality culture within their organisations.

Originality/value – This is a new methodology, containing a developed questionnaire and an interviewguide, aiming to assess and evaluate teamwork within TMTs and sustainable quality culture. The practice ofthe methodology adds value to both TMTs and their organisations, as well as provides a theoretical andmethodological contribution to research on teamwork and sustainable quality culture.

Purpose: The purpose of this paper was to present success factors for increasing quality and safety of intensive care unit (ICU) transitional care as described by co-workers at the sharp end using the core values of total quality management (TQM) as a theoretical lens.

Methodology/Approach: The study had a qualitative design, with data from nine interdisciplinary focus group discussions, including co-workers from the intensive care and general wards. Data were sorted into TQM core values and analysed using qualitative content analysis.

Findings: Quality and safety in transfer processes requires a holistic view, avoiding silos, shared arenas for collaboration, and evidence-based methodologies and tools for safe transfers.

Research Limitation/Implication: A limitation of this study is that it only portrays the challenges encountered by two hospitals during the process of transitional care in the ICU.

Originality/Value of paper: By using TQM core values as a theoretical lens, we could present a usable, holistic picture of success factors and how to improve the transfer process.

Purpose: To explore how teamwork and sustainable quality culture relate to each other in transitional care from the perspective of intensive care personnel.

Methodology: The questionnaire ‘Assessing Quality Culture Health Care edition’ (Sten et al., 2021) was used to measure teamwork and sustainable quality culture within an ICU setting. This questionnaire consisted of 50 statements and 16 factors.The results were statistically analysed using SPSS. Initially, no significant differences in scores were found between the two ICUs. Consequently, the results were treated as one set of data. Pearson’s Product-Moment Correlation was used to compare the measured factors for team collaboration within and between hospital units (6 factors) and the measured factors for sustainable quality culture (10 factors) to determine whether the factors correlated with each other. Correlations with an R-value above 0.50 (significant level 0.01) were considered high and treated as a correlation.

Findings: All means for the factors measuring teamwork within hospital units were higher than the factors measuring teamwork between hospital units, which could indicate a lack of system view. The results also showed that it was only the factors measuring teamwork within hospital units that correlated to four of the sustainable quality culture factors, namely ‘AI’, ‘Pride’, ‘System view’ and ‘Continuous improvement’. The sustainable quality culture factors, ‘Leadership commitment’ and ‘Participation of everybody’, did not correlate with any of the factors concerning teamwork. This result suggest that these factors might need to be adjusted in the questionnaire to fit within the healthcare context.

Research limitations/implications: This research is limited to intensive care personnel’s perceptions of transitional care at two medium-sized hospitals located in rural areas of Sweden.

Originality/Value: No studies have been found that investigate the relationship between teamwork and sustainable quality culture within transitional care from the perspective of intensive care personnel. A sustainable quality culture can have an impact on teamwork and therefore also on patient safety. Insights from this study may have practical implications for the development of teamwork and sustainable quality culture within health care aimed at increasing care quality and patient safety.