Sofie Pilemalm

Third generation participatory design in health informatics-Making user participation applicable to large-scale information system projects

Participatory Design (PD) methods in the field of health informatics have mainly been applied to the development of small-scale systems with homogeneous user groups in local settings. Meanwhile, health service organizations are becoming increasingly large and complex in character, making it necessary to extend the scope of the systems that are used for managing data, information and knowledge. This study reports participatory action research on the development of a PD framework for large-scale system design. The research was conducted in a public health informatics project aimed at developing a system for 175,000 users. A renewed PD framework was developed in response to six major limitations experienced to be associated with the existing methods. The resulting framework preserves the theoretical grounding, but extends the toolbox to suit applications in networked health service organizations. Future research should involve evaluations of the framework in other health service settings where comprehensive HISs are developed.

How do Shop Stewards Perceive their Situation and Tasks? : Preconditions for Support of Union Work

When unions worldwide confront a decline in density and power, pressure increases on shop stewards. They occupy a position desribed s demanding, which involves striking a balance between conciliation and tough negotiation, between ordinary work and union work, and feelings of isolation from members. If shop stewards already experien a demanding work situation, and parallel to this the overall union conditions become aggravated, a next step would be to find out in what ways their situation can be facilitated. This article is based on data desribing recent experiences of Swedish shop stewards, and it compares their situation to that desribed in the international research literature. It is found that the basic components of union work remain stable, in spite of rent labour relations changes and national differences. However, lees than half of the reported problems were related to direct contact with the employer. Shop stewards generaly experience a situation characterized by inherent conflict and wide-ranging tasks, resulting in high demands on their skills and in role overload. On the other hand, the results indicate differences with regard to the ulnion affilation, age, experience and gender. En the eyes of union members the shop stew ards largely emb ody the ui on organizati on. Therefore, they should reeive increased attention when dealing with the problems of unions. Measures to facilitate their work can include training, supportive networks and access to adequate information technology, and can further be targeted with regard to age/experience and gender.

Emergency Response in Rural Areas

In this study, security and safety in rural parts of Sweden are investigated. New ways of organizing for efficient response can be found in the extended collaboration between societal sectors and i ...

Intentions to Perform Non-Pharmaceutical Protective Behaviors during Influenza Outbreaks in Sweden: A Cross-Sectional Study following a Mass Vaccination Campaign

Failure to incorporate the beliefs and attitudes of the public into theoretical models of preparedness has been identified as a weakness in strategies to mitigate infectious disease outbreaks. We administered a cross-sectional telephone survey to a representative sample (n = 443) of the Swedish adult population to examine whether self-reported intentions to improve personal hygiene and increase social distancing during influenza outbreaks could be explained by trust in official information, self-reported health (SF-8), sociodemographic factors, and determinants postulated in protection motivation theory, namely threat appraisal and coping appraisal. The interviewees were asked to make their appraisals for two scenarios: a) an influenza with low case fatality and mild lifestyle impact; b) severe influenza with high case fatality and serious disturbances of societal functions. Every second respondent (50.0%) reported high trust in official information about influenza. The proportion that reported intentions to take deliberate actions to improve personal hygiene during outbreaks ranged between 45–85%, while less than 25% said that they intended to increase social distancing. Multiple logistic regression models with coping appraisal as the explanatory factor most frequently contributing to the explanation of the variance in intentions showed strong discriminatory performance for staying home while not ill (mild outbreaks: Area under the curve [AUC] 0.85 (95% confidence interval 0.82;0.89), severe outbreaks AUC 0.82 (95% CI 0.77;0.85)) and acceptable performance with regard to avoiding public transportation (AUC 0.78 (0.74;0.82), AUC 0.77 (0.72;0.82)), using handwash products (AUC 0.70 (0.65;0.75), AUC 0.76 (0.71;0.80)), and frequently washing hands (AUC 0.71 (0.66;0.76), AUC 0.75 (0.71;0.80)). We conclude that coping appraisal was the explanatory factor most frequently included in statistical models explaining self-reported intentions to carry out non-pharmaceutical health actions in the Swedish outlined context, and that variations in threat appraisal played a smaller role in these models despite scientific uncertainties surrounding a recent mass vaccination campaign.

Practical experiences of model-based development: Case studies from the Swedish Armed Forces

This study explores practical experiences of model-based development and implementation, focusing on “lessons identified.” The study draws on experience from several case studies in the Swedish Defence domain using semistructured interviews as the major source of information. The study identifies several conditions as being crucial for successful implementation of model-based development work, including an increased focus on the planning and premodeling phase, a need for interorganizational or across-project collaboration, scalability, change management, and documentation and reuse of experiences. It was also found that most of the challenges identified in the model-based development and implementation processes are common organizational and system development related problems such as change management, the issue of user participation, and how to carry out requirements engineering based on the models. Therefore, future research in the area should aim for a more integrative perspective, for instance, bridging the gap between information collection, models, user needs, and organizational and system requirements.

Quality Driven Requirements Engineering for Development of Crisis Management Systems

Terror attacks and natural disasters of the past decades have dramatically made governments, public health authorities, and communities aware of insufficiencies in crisis management practices. Information technology has the potential to advance these practices, but systems that support handling these courses of events still have low success rates. The authors set out to define a requirements engineering method suitable for the development of crisis management systems (CMS). The resulting method was formatively evaluated in a project aimed at defining functions for systems supporting international engagements in crisis situations. Each step in the method was documented by its objective, output, implementation, and the experiences gained from the case study. The most important features of the method are the Voice of the Customer Table for identification of user needs, Use Cases for determination of requirements from the needs, and scenarios and prototypes for validating the requirements with user representatives.

Enabling organizational learning from rescue operations

Purpose – The purpose of this paper is to explore the re-development process of the Swedish Rescue Services Incident Reporting System from an organizational learning perspective with the purpose to suggest what is needed to enable long-term learning from rescue operations. Design/methodology/approach – The study is carried out as a case study relying on interviews, participant observation and workshop methods. The study case is the Swedish Incident Reporting System. Findings – The objectives expressed by the central agency leading the studied process aimed at implementing double-loop learning objectives by revising the incident reports and to improve future operations accordingly. In practice this objective was lost along the way, with the agency focussing on cosmetic changes to the report such as terminology, attributes and labels. Meanwhile the local rescue services expressed different and concrete needs, requiring new system functionality, case/experience based learning, process improvements and organi...

Emerging forms of inter-organizational and cross-sector collaborations in e-government initiatives : Implications for participative development of information systems

Purpose – This study aims to explore recent public sector trends, inter-organizational and cross-sectorcollaborations, and analyzes these in terms of implications for participative development of i ...

Actor-centred emergency response systems: a framework for needs analysis and information systems development

A new trend in emergency response systems (ERS) is to create new forms of collaboration, for example, by involving new resources in response operations, in order to compensate for the limited numb ...

Participatory Design in Emerging Civic Engagement Initiatives in the New Public Sector: Applying PD Concepts in Resource-Scarce Organizations

In this study, we address the role of Participatory Design (PD) in emerging public sector governance forms and, more specifically, civic engagement and we-government initiatives. We achieve this by first providing a research overview of the development of PD approaches since they originated in the 1970s, identifying different PD generations and associated concepts, contexts, and challenges, and then relating them to current public sector trends. Next, we link the overview to a practical example by presenting a case of applying PD to a civic engagement project that takes place in the Swedish emergency response system. Our example findings sustain previously identified needs to return to broad change processes and balance this with ICT re-configuration and structuration of the collaborative processes, the related stakeholders, and their needs, this time in a context where work tasks and responsibilities are not yet defined, known or experienced among stakeholders. We then suggest methodological ways to handle this by (1) applying an interdisciplinary PD approach, (2) replacing the traditional design group with a combination of various qualitative methods and PD techniques, e.g., focus groups, modified scenario-based future workshops, exercises, and after-action-reviews, and (3) support PD activities with context-specific frameworks. We argue that applying PD concepts to the governance forms that are emerging in resource-constrained public sector organizations poses a number of challenges, many of them relating directly to the unknown character of the work setting and the practical difficulties of involving civil citizens as end-users. However, if they are addressed and handled adequately, making civic engagement initiatives work processes and ICT support to work smoothly, this can contribute to a re-politicization of PD in terms of space, action, and the empowerment of citizens both by enhancing their skills and by having them represented in design activities.