A New Way of Thinking and Talking About Economy: Clinic Managers' Perspectives on the Sustainable Implementation of a Decommissioning Programme in Sweden.

Healthcare systems may run into economic problems that may require 'active' decommissioning by policy-makers and managers. The aim of this study was to investigate, from a sustainability perspective, the implementation of an extensive decommissioning programme in one of the Swedish regions. Intervie...

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Publicado en:Health Services Insights pp. 1 - 8
Autores principales: Fredriksson, Mio, Gustafsson, Inga-Britt, Winblad, Ulrika
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 7/31/2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 7/31/2023
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: A New Way of Thinking and Talking About Economy: Clinic Managers' Perspectives on the Sustainable Implementation of a Decommissioning Programme in Sweden.
      aug:
        au:
          Fredriksson, Mio
          Gustafsson, Inga-Britt
          Winblad, Ulrika
        affil: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
      sug:
        subj:
          Diffusion of Innovation
          Health Facility Administrators Psychosocial Factors
          Sustainable Growth Sweden
          Program Implementation
          Health Facility Administration
          Health Facilities Economics
          Organizational Change
          Financial Management
          Human
          Funding Source
          Sweden
          Semi-Structured Interview
          Program Evaluation
          Budgets
          Leadership
          Thinking
          Decision Making, Shared
          Interpersonal Relations
          Patient Care
          Health Facility Closure
          Physician Executives
          Nurse Executives
          Interview Guides
          Quality of Health Care
          Quality Improvement
          Organizational Compliance
          Organizational Culture
      ab: Healthcare systems may run into economic problems that may require 'active' decommissioning by policy-makers and managers. The aim of this study was to investigate, from a sustainability perspective, the implementation of an extensive decommissioning programme in one of the Swedish regions. Interviews were performed with 26 clinic managers 3 years after initial implementation. Those were analysed inductively, and then discussed based on a model of potential influences on sustainability. Although the programme was only 'partly sustained', the result point to a sustained attention to the health system's poor economy, visible in a great effort by the clinics to maintain their budgets. The most important influences were intervention fit and modifications made at the clinic level (i. innovation characteristics), clinic and health system leadership (ii. context), champions (iii. capacity) and shared decision-making and relationship building (iv. processes and interactions). When implementing decommissioning, it is particularly important to engage managers responsible for the care of patients and clinic budgets from an early stage and to allow them to design approaches based on the staff's and managers' detailed knowledge of the situation at their clinics and of the disease area, that is, to achieve fit at the clinics. In this way, the decommissioning approaches can more likely get the character of quality improvement efforts, which increases sustainability and may lead to positive quality outcomes. Despite being unpopular, the study suggests that decommissioning can have positive effects as well, such as creating opportunities to make difficult but necessary changes and fostering increased collegial support during the centralisation of services.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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