Forte has produced a report about the projects that have been funded within their call for work enviornment research in women dominated professions. The Disa project is found on the last page.
The folder is found here (in Swedisg): http://forte.se/wp-content/uploads/2017/04/kvinnodominerade-sektorer-webb.pdf
Recommended read for the curious person!
Last Friday, Ida, Gerolf and I had a very instructive and thought-provoking meeting with one of the team members working on value-based care at the Uppsala University Hospital. The hospital is indeed in the process of optimizing its care-delivery processes in order to provide patients with both a better experience with hospital-based treatments and a higher quality of care. This relatively new, international “value-based” approach has its origins in the realization that hospital-based care processes lack efficiency and, from a patient perspective, objective ways to evaluate their quality. Statistics frequently used to assess the quality of the provided care include for example the number and the length of hospital visits, which the value-based approach argues are not actually representative of quality. More meaningful quality factors from a patient-centered perspective include for example how the patient feels, how quickly a diagnosis is established or whether the treatment is effective (whether the symptoms are effectively reduced by the treatment). As such, the value-based care optimization process aims to achieve quality in terms of patient-centered factors as well as provide valid measurements for the different factors taken into account, i.e. make it possible to evaluate the achieved quality level from a patient perspective. To carry out this high-level optimization process, the value-based care team at the Uppsala University Hospital is working together with inter-department groups of clinicians, for example in the form of workshops, in order to model the existing care flows and identify ways they can be improved as well as meaningful evaluation measurements.
Although those high-level organizational changes are beyond the scope of the DISA-project, it was important for us to get an insight into this change process currently taking place at the Uppsala University Hospital. Those workflow changes may indeed influence the documentation procedures (most of which are carried out digitally), and a good understanding of those procedures, their context and their purpose is essential in order to be able to interpret correctly what we will hear and observe while out in the field throughout the project.
Personally, I wonder whether a similar optimization could be applied to the doctors and nurses’ digital work environment. However, if patient-centered quality factors are relatively easy to come up with, the task is more complex when it comes to digital, nurse-centered processes. When it comes to computer-mediated documentation and, more generally, care delivery, what is quality? How can we assess and ensure that the existing digital workflows support nurses’ efficiency and well-being? I really hope that our work within the DISA-project will make it possible for us to answer those questions.
Jonas Moll and Åsa Cajander from HTO has worked together with a large group of researcher and the EU coordinators at Uppsala University in writing an application to Horison2020. We have been working on this and having meetings about this since the early fall, so this has taken quite a lot of time, and the application is around 14o pages of text including everything. This week the application was finally submitted, and it looks very good.
Writing this kind of large application requires good coordination, and we really had excellent coordinators this time which gives a good indication of the work in the future project.
If funded both Jonas Moll and Åsa Cajander will be working in the project and be in charge of one of the work packages.
Let’s hope that the application is granted!
Anticipating exactly what will resonate with your audience is not always easy. During the last couple of weeks I have been presenting some results from a study on the healthy digital workplace, as a part of the SISU-project. The presentations were part of the studied organisations change effort and my presentation was one part, embedded in the information from the organisations project leaders. The overall message was thus one of progress. The study I presented created a baseline for measuring the effects of the coming changes. It also indicated some strategic areas to observe during the change.
The one thing that really seemed to catch everyones attention was not so much the results as one of the slides I used to frame my message. In this slide I contrasted the idea of a linear progression from the current state to the next with the classic J-curve or change curve as it might be called (originally the Kübler-Ross model describing grief). The J-curve in this context is mainly a rhetoric tool, it presents a generic path through change, the big difference to the simple linear progression is the understanding that things will get worse, before they get better. As basic as this concept might seem, it did however seem to catch the interest of both managers and employees. It did seem as if it created a common ground for discussing the upcoming challenges.
As time was limited I did not expand on the concept however. Taken at face value it might be misunderstood as support for the idea of simple linear progression (A->B), just with a more bumpy road. In practice there are at least two waypoints that should be noted. The first is that there is a worst case scenario where there is no recovery and the change not only fails but even fails miserably (C). The second is that if the organisation navigates the turmoil it might still end up in some kind of status quo or rather same same but different (D). The promise of actual progress still needs to be fulfilled. Taking a note from Festinger’s theory of cognitive dissonance one might suspect that we might be tempted to rationalize our new position as an improvement without this actually being the case. Thus, we need to be careful to measure the right aspects during a change effort.
Finally, I didn’t use my favorite take on the change curve, namely the hype curve (hype cycle) made famous by Gartner. The inclusion of the hype is interesting as it puts focus on the rhetoric behind the change. Getting the boards interest and approval might well include some mild exaggerations regarding the benefits of the change. As is obvious from the hype curve the discrepancy between these promises and the coming turmoil might turn out rather dramatic. Thus, it is–as we all should know–important to manage expectations during change so as to avoid a roller coaster experience of change.
Come and work with us in the HTO research group. We are looking for a post doc for two of our action research projects.
The HTO group is going to be present at Vitalis 2017 which is one of the national conferences in health care. We will present in two different tracks this year:
- Medical Records Online (Journal via nätet – en maxxad tillställning). Jonas Moll will be presenting the latest results from the patient survey that was sent out in the summer. Åsa Cajander will be presenting together with Isabella Scandurra. We will also present our new Disa project to the audience in this track 🙂
- Envisioning Technology in Healthcare in 2015. Åsa Cajander will be presenting a project made in the IT in Society course together with Laura Wiegand, Mikaela Eriksson and Anna Normark.
There will be quiet many from the HTO group present at Vitalis, and we are all looking forward to an exciting trip 🙂
See you at Vitalis!
This spring we are doing a campus tour around Uppsala university to inform about the future changes that are coming up. As you might remember we have an action research project, Sisu, with the local Ladok implementation project, see this blog post .
The content of the seminars:
- Short presentation of project.
- Demonstration of the system.
- What is “digital workenvironment”
- Results from the survey “The digital work environment of study administrators”
- Some advice to the departments for handling this change
We have the following upcoming seminars planned:
7 april, 10.15-11.45. BMC, sal B/A 111a.
10 april, 13.15-14.45. Gamla torget, sal T/GT6_3576.
11 april, 12.15-13.45 Engelska parken. Geijersalen.
19 april, 12.30-14.00. Blåsenhus, Laborativa lärosalen. Med videolänk till Campus Gotland: rum B23.
You find updated infomration about New Ladok on the university information page