Clinicians' psychological empowerment to engage in management as part of their daily work

This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and noncommercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcodePurpose – The purpose of the article is to analyze how physicians and nurses, as the two major health care professions, experience psychological empowerment for managerial work. Design/methodology/approach – The study was designed as a qualitative interview study at four primary care centers (PCCs) in Sweden. In total, 47 interviews were conducted, mainly with physicians and nurses. The first inductive analysis led us to the concept of psychological empowerment, which was used in the next deductive step of the analysis. Findings – The study showed that both professions experienced self-determination for managerial work, but that nurses were more dependent on structural empowerment. Nurses experienced that they had competence for managerial work, whereas physicians were more ignorant of such competence. Nurses used managerial work to create impact on the conditions for their clinical work, whereas physicians experienced impact independently. Both nurses and physicians experienced managerial work as meaningful, but less meaningful than nurses and physicians’ clinical work. Practical implications – For an effective health care system, structural changes in terms of positions, roles, and responsibilities can be an important route for especially nurses’ psychological empowerment. Originality/value – The qualitative method provided a complementary understanding of psychological empowerment on how psychological empowerment interacted with other factors. One such aspect was nurses’ higher dependence on structural empowerment, but the most important aspect was that both physicians and nurses experienced that managerial work was less meaningful than clinical work. This implies that psychological empowerment for managerial work may only make a difference if psychological empowerment does not compete with physicians’ and nurses’ clinical work.publishedVersio

En hållbar balansakt över tiden

Med anledning av Björn Brorströms 60-årsdag bjöds alla hans gamla doktorander från Förvaltningshögskolan vid Göteborgs universitet in att skriva var sin text till denna festskrift. Björn var verksam som professor och senare även prefekt vid Förvaltningshögskolan mellan åren 1996 och 2006. Under denna tidsperiod handledde han tio doktorander mot sin examen. Sedan 2006 är Björn verksam vid högskolan i Borås, först som prorektor och nu som rektor. Detta har inte fått honom att släppa taget om forskningen då han fortfarande har uppdrag vid det forskningsinstitut han en gång grundade; Kommunforskning i Västsverige (KFi). Vi gamla doktorander har känt Björn olika länge och arbetat tillsammans med honom i olika utsträckning, men vi har en sak gemensamt och det är att Björn lämnat avtryck hos oss och i vår forskning. Dessa avtryck finns samlade i föreliggande skrift som innehåller nio texter som på olika sätt beskriver Björn och hans forskargärning. Några av texterna fokuserar på Björns avtryck i ett större sammanhang och därmed hans bidrag till forskarsamhället i stort. Andra texter fokuserar mer på Björns avtryck i det lilla hos den enskilde författaren. Texterna bjuder därmed på både personliga minnen från handledarmöten, seminarier och annat, men också på beskrivningar av spår som Björn lämnat i mer vetenskapliga sammanhang. Eller som man inom akademin brukar uttrycka det; hans bidrag till det vetenskapliga samtalet

Förtroende för vårdens information

Nya teknologier i sjukvården skall ge effektivare informationsflöden och bidra till att behandla patienter snabbare och effektivare. Syftet är att beskriva och analysera professionernas tillit till informationen i den digitala patientjournalen. I en jämförande studie med den tidigare analoga patientjournalen besvarar en enkätundersökning till läkare (n=65) och sjuksköterskor(n=262) (svarsfrekvens 84,7%), tilliten till informationens stöd, möjligheter och utmaningar för professionernas kunskap och förmåga att tillämpa informationen. Den horisontella tilliten mellan professionerna stöder tillit till informationen i patientjournalen. Tilliten är dock låg till att informationen effektiviserar användning av informationen. Det är inte digitalisering i sig som utvecklar tillit till informationen utan tillit mellan dem som arbetar med patienterna. När tilliten mellan professionerna ökar finns möjlighet till ytterligare samarbete i sjukvården.New technologies in health care shall provide more efficient information flows and contribute to treat patients more efficiently. The purpose describes and analyzes the professionals’ trust to the information in electronic healthcare records, compared to the former analogue. A survey of physicians’ (n = 65) and nurses’ (n = 262) (response rate of 84.7%) perceptions was performed about trust of the information regarding support, opportunities and challenges, and the professionals’ knowledge and ability to apply this information. The horizontal trust between professionals supports trust of the information. Digitized information, in itself, does not render the use of information more efficient. However, it is not digitalization that develops trust in the information without the trust between those working with the patients

Förtroende för vårdens information

Nya teknologier i sjukvården skall ge effektivare informationsflöden och bidra till att behandla patienter snabbare och effektivare. Syftet är att beskriva och analysera professionernas tillit till informationen i den digitala patientjournalen. I en jämförande studie med den tidigare analoga patientjournalen besvarar en enkätundersökning till läkare (n=65) och sjuksköterskor(n=262) (svarsfrekvens 84,7%), tilliten till informationens stöd, möjligheter och utmaningar för professionernas kunskap och förmåga att tillämpa informationen. Den horisontella tilliten mellan professionerna stöder tillit till informationen i patientjournalen. Tilliten är dock låg till att informationen effektiviserar användning av informationen. Det är inte digitalisering i sig som utvecklar tillit till informationen utan tillit mellan dem som arbetar med patienterna. När tilliten mellan professionerna ökar finns möjlighet till ytterligare samarbete i sjukvården.New technologies in health care shall provide more efficient information flows and contribute to treat patients more efficiently. The purpose describes and analyzes the professionals’ trust to the information in electronic healthcare records, compared to the former analogue. A survey of physicians’ (n = 65) and nurses’ (n = 262) (response rate of 84.7%) perceptions was performed about trust of the information regarding support, opportunities and challenges, and the professionals’ knowledge and ability to apply this information. The horizontal trust between professionals supports trust of the information. Digitized information, in itself, does not render the use of information more efficient. However, it is not digitalization that develops trust in the information without the trust between those working with the patients

Interprofessional barriers : A study of quality improvement work among nurses and physicians

This article studies interprofessional barriers between nurses and physicians in the context of quality improvement work. A total of 17 nurses and 10 physicians were interviewed at 2 hospitals in Sweden. The study uncovered a number of barriers relating to both the relative status of each group and their defined areas of responsibility

Interprofessional barriers : A study of quality improvement work among nurses and physicians

This article studies interprofessional barriers between nurses and physicians in the context of quality improvement work. A total of 17 nurses and 10 physicians were interviewed at 2 hospitals in Sweden. The study uncovered a number of barriers relating to both the relative status of each group and their defined areas of responsibility

Patient Empowerment and its Connection to Trust

Patient Empowerment (PE) allows patients to be more active in managing their own health and quality of life. The aim of this paper is to analyze how trust affects PE, in the context of healthcare information systems. An interview study was conducted concerning patients’ online access to electronic healthcare records. Results show that PE requires that patients trust the information that healthcare professionals and their electronic health record systems provide. Without trust, patients cannot control their own participation in relation to the healthcare professionals. This may result in a diminished ability to participate in the healthcare processes regarding their own care. Practical implications include acquired knowledge about and awareness of how trust influences PE, with particular emphasis on healthcare professionals. A trust model is presented that illustrates the trustor-trustee dimensions of PE. This model has both theoretical and practical implications in its illustration of how trust and PE connect.  CC BY-NC-ND 4.0</p