Thim Prætorius

Quality in Healthcare

book 9th NOVO Symposium, Quality in health care DTU Orbit (10/11/2019) Abstract book 9th NOVO Symposium, Quality in health careConclusions: • Both the ErgoVSM and VSM tools seem mostly to result in intervention proposals causing improved or no change in the work environment without impaired performance. • Based on Swedish data only the use of ErgoVSM may result in some improvement of the work environment compared with VSM. Such an effect is weakly supported by the Icelandic data and not by the Danish data. Thus, only under some conditions the ErgoVSM tool may be used in favour of the VSM tool. • Most proposals were assessed to cause ergonomic improvements at system level (‘job content’ and ‘work situation’). This is in contrast to intervention proposals investigated in the ergonomic intervention literature mainly focusing task level and the individual (cf. Westgaard and Winkel, 2011).

How to achieve care coordination inside health care organizations: Insights from organization theory on coordination in theory and in action

Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high-quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from organization theory, where coordination is a central research topic. The article focuses on intra-organizational coordination, which is challenging especially across boundaries such as departments or professions. It provides an overview of the classic coordination mechanisms, e.g., standardization of work processes, but also of recent insights that have identified the conditions that are required to achieve coordination, and how these conditions can be provided by formal mechanisms, such as standardization, but also informally by drawing on features of the emerging situation. Such research highlights the contribution of, e.g., routines like those guided by care pathways or of artifacts like displays. The coordination insights are also discussed as regards inter-organizational care coordination.

Achieving Better Integration in Trauma Care Delivery in India: Insights from a Patient Survey

Interdependencies among healthcare providers result in complex healthcare supply chains with fragmented healthcare processes characterized by coordination failure and incentive misalignment. In developing countries where resources are scarce such coordination failures can have a severe impact on patient health. However, limited knowledge exists about how coordination takes place across and within the different healthcare service providers and how this influences hospital transfer time and length of stay. This article research this gap by studying trauma care delivery in India using a patient survey (n = 104). The Indian healthcare system is insightful because India has to provide low-cost care to large populations living in geographically big areas and the healthcare infrastructure struggles to meet increasing demands. The findings suggest mechanisms to better integrate the processes from the accident site to the hospital which include setting up referral processes, 24-hour ambulance services, using third-party coordinators and process improvement within the hospital following lean principles.

How to Write (Even) Better Academic Student Reports and Papers: Some Advices to Students

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Improving care coordination using organisational routines: Care pathways as a coordination mechanism

PURPOSE The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. DESIGN/METHODOLOGY/APPROACH Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. FINDINGS Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications - The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. PRACTICAL IMPLICATIONS The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value - Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

The collaborative hospital: Observations from practice

book 9th NOVO Symposium, Quality in health care DTU Orbit (10/11/2019) Abstract book 9th NOVO Symposium, Quality in health careConclusions: • Both the ErgoVSM and VSM tools seem mostly to result in intervention proposals causing improved or no change in the work environment without impaired performance. • Based on Swedish data only the use of ErgoVSM may result in some improvement of the work environment compared with VSM. Such an effect is weakly supported by the Icelandic data and not by the Danish data. Thus, only under some conditions the ErgoVSM tool may be used in favour of the VSM tool. • Most proposals were assessed to cause ergonomic improvements at system level (‘job content’ and ‘work situation’). This is in contrast to intervention proposals investigated in the ergonomic intervention literature mainly focusing task level and the individual (cf. Westgaard and Winkel, 2011).

Bureaucracy friend or foe? - organizing for social capital in hospitals

book 9th NOVO Symposium, Quality in health care DTU Orbit (10/11/2019) Abstract book 9th NOVO Symposium, Quality in health careConclusions: • Both the ErgoVSM and VSM tools seem mostly to result in intervention proposals causing improved or no change in the work environment without impaired performance. • Based on Swedish data only the use of ErgoVSM may result in some improvement of the work environment compared with VSM. Such an effect is weakly supported by the Icelandic data and not by the Danish data. Thus, only under some conditions the ErgoVSM tool may be used in favour of the VSM tool. • Most proposals were assessed to cause ergonomic improvements at system level (‘job content’ and ‘work situation’). This is in contrast to intervention proposals investigated in the ergonomic intervention literature mainly focusing task level and the individual (cf. Westgaard and Winkel, 2011).

The collaborative hospital: a multiple, embedded case study

The rapid spread of Lean implementation within the health care sector has made it urgent to evaluate the effects of Lean on productivity, working conditions and health. Therefor an instrument is ne ...Introduction A model for Good Work, understood as positive and rewarding aspects of work, has previously been developed based on interviews including dentists working under different organizational systems. An overall finding was that a positive work climate with trustful relations and professional freedom was found important for being able to carry out high quality work. The aim of this presentation is to assess whether the central part of this model can be corroborated empirically.