Learning about the conditions for improvement and excellent care from high performing clinical networks
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Abstract
We are learning from high performing professionals why things go right in healthcare. Using a mixed method approach, a combination of six conditions for successful services and improvements were found: (1) Invisible web of interaction. Professionals with defined roles and tasks are working and learning together in multiprofessional teams, with a common desire to make a positive difference together with their patients. (2) Management by trust, knowledge and data collection. Leading and continually improving the system in a climate of empowerment. Developing easily available plans and clearly defined roles and responsibilities. (3) Fostering creative ability. No plan can cover everything that may happen. With a good structure, knowledge and trust, good improvisations are made, allowing the team to do what the situations demands. (4) Minimizing the number of handoffs in the care process to prevent adverse events. (5) Monitoring current practices and change. Reflecting together on the variations in practice using longitudinal control charts and video-recorded training sessions. Making decisions based on findings. (6) Easily available professional and improvement knowledge and guidance.List of papers
Paper I: Development and Validation of the CPO Scale, a New Instrument for Evaluation of Health Care Improvement Efforts. Aleidis Skard Brandrud, Gro Sævil Helljesen Haldorsen, Bjørnar Nyen, Mari Vårdal, Eugene C. Nelson, Leiv Sandvik, Per Hjortdahl. Q Manage Health Care 24(3):109–120. DOI: 10.1097/QMH.0000000000000065. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1097/QMH.0000000000000065 |
Paper II: Domains associated with successful quality improvement in healthcare – a nationwide case study. Aleidis Skard Brandrud, Bjørnar Nyen, Per Hjortdahl, Leiv Sandvik, Gro Sævil Helljesen Haldorsen, Maria Bergli, Eugene C. Nelson and Michael Bretthauer. BMC Health Services Research (2017) 17:648. DOI: 10.1186/s12913-017-2454-2. The article is included in the thesis. Also available in DUO at: http://urn.nb.no/URN:NBN:no-61069 |
Paper III: Local emergency medical response after a terrorist attack in Norway: a qualitative study. Aleidis S Brandrud, Michael Bretthauer, Guttorm Brattebø, May JB Pedersen, Kent Håpnes, Karin Møller, Trond Bjorge, Bjørnar Nyen, Lars Strauman, Ada Schreiner, Gro S Haldorsen, Maria Bergli, Eugene Nelson, Tamara S Morgan, Per Hjortdahl. BMJ Qual Saf 2017;26:806-816. DOI: 10.1136/bmjqs-2017-006517. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1136/bmjqs-2017-006517 |