AbstractOur purpose for making this study is to study the implementation, the use of and the effects of Lean within our case objects.  We chose to make this thesis by case studies. The three themes mentioned above is also the main research questions that we aim to find an answer to by this study. We have chosen to do a cross section analysis where we conducted structured interviews to find answers to these questions. The theoretical reference frame consists partly of traditional theoreticians within Lean but also more recent research within the subject as well as theory specifically for Lean within the Health Care sector.The result of this study shows in all our case studies that the Management has been supporting the implementation, but that the implementation process proceeds faster if also the professionals are involved in the process.  To succeed with the implementation there is a great need for good reasons and strives that can benefit the professionals. By the use of Lean our case studies have evaluated its processes, with the main intentions being to reduce waste activities and to create flows with ?pull systems?.

Placed in an institution, what happens next? A study concerning how social workers handle the after-care of adolescents who earlier has been placed in an institution is written by Therese Wester and Sanna Sjölander Wirlöf. The purpose of the study is to understand and explain how social workers handle the after-care. This study is based on an organizational perspective since the after-care has been studied in relation to the structure of the organization and the laws and guidelines that the organization has to relate to. The method that has been used is semi-structured interviews with six social workers in different municipalities in Stockholm.

In the year of 2009 the conditions for managing primary healthcare in the region of Västra Götalandchanged. The decision was taken by the regional assembly and resulted in that the citizens since thenhave had the opportunity to choose which health care provider they preferto stay with. Along with thisdecision a new market for private health careproviders was established, which resulted inincreasedcompetition between the providers.In order to manage the competition, the health care providers arenow forced to be more efficient in their operations andalso to beeven more focused on their patients.Backa Läkarhusgruppen is an example of a private healthcare provider in the region of Västra Götaland.In the same way it is also an example of anorganizationin need of analysing their operations to seehowit can be further optimized to meet patient needs and expectations.The aim of this study is to analyse Backa Läkarhusgruppen?s organization and its operationsin the hopeoffinding suggestions whichwill improve the patient flow.To allocate and solve the problems thatBacka Läkarhus suffer from,an approach inspired by Lean Healthcare is used throughout the report.Some of themost significant problems that were identified within the organization are:?The synchronization of demand and capacity is inadequate.?Absence of standardized routines.?Absence of present leadership.To be able to improve the patient flow Backa Läkarhus needs to handle these identified problem areas.By synchronizing the staffing level in relation to the trends in demand a reduction in the patient?swaiting times and throughput time will be possible. Creating clear responsibilities and routines for thestaff will contribute to a higher degree of patient focus and thus lead to a more efficient patient flow.

In this thesis you will meet people that are members of a ?health-choir?. This people are singing together once a week and the purpose is to get a better health. You will also see if choir-singing can be seen as A rites of Passage. You will get a direct link to the informants.

This study is based on interviews with four managers in public elderly care and four managers in private elderly care. The aim of this paper is to examine how these managers are experiencing their leadership in relation to conflict management, and if the managers leadership differs depending on private or public elderly care. Leadership and conflict management are theories that have been used in order to analyze the empirical findings. Previous research that has been used in the study concerns ?leadership/leadership styles?, ?conflict management?, ?to be active in the private/public elderly care?.

The overriding purpose of this graduate thesis is to evaluate if municipalities and county councils can deviate from the legislation of public procurement during procurement of customer choice agreements within the health and social care area. The intention of this Quasi-market is to provide the users with competition in terms of quality rather then the general principal rule of economic value.My conclusion results in a legal situation without rules of general procedure. So far the authorities make their own regulation in the field of customer choice agreements. The problem lies within the authorization of new contractors and their right to make an appeal against resolutions made by the authorities social care divisions.One solution is to legislate within the present law of public procurement. Another way to solve the problem is to create a lex specialis apart from the present public procurement regulation..

Syftet med föreliggande studie var att redogöra för hälso- och sjukvårdspersonalens följsamhet till hygienföreskrifter avseende handhygien och de faktorer som påverkar detta. Metod: Artiklar söktes via CINAHL, Pubmed och Scopus. Sökord som användes i olika kombinationer var: hand hygiene, adherence, hygiene guidelines, health care workers, compliance, hand disinfection, infection control, nursing, nurse och hand cleansing. Tretton vetenskapliga artiklar erhölls. Vidare gjordes en manuell sökning ifrån inkluderade artiklars referenslistor och genererade två artiklar som ingick i resultatet.

The workplace is perhaps the most developed arena for prevention of diseases and injuries among employees. In addition, according to the Swedish Work Environment Act, the employer is responsible to address physical and psychosocial risk factors. Moreover, many employers use health promotion, primarily related to individuals and their ambition to maintain or improve health, for example through dietary means and exercise. The aim of this study is to investigate health inspirers in municipal activities and their perceived support and motivation in work related to health promotion at the workplace. A qualitative method was chosen where six health inspirers within Ludvika kommun were interviewed.

Reasons for performing this study: Colic has for a long time been seen as a serious health problem in the equine population. Even so, the knowledge of colic seems to differ a great deal among the people interacting with horses. A large number of studies have for several years looked at risk factors that cause colic, in order to provide knowledge about them. The knowledge can then be used as tools for developing prophylactic methods in order to reduce the number of horses that develop colic. Objectives The aim with this study was to investigate if people have the correct knowledge about colic in horses, which risk factors that cause colic today and describe prophylactic methods that can result in avoidance of colic in horses. Method Eleven veterinary practices were contacted in order to send out two questionnaires for a study of six weeks.

 The upper secondary school has a responsibility to give every student enough knowledge for a healthy life after they finished school, this is stated in the curriculum. Although the way of reaching this knowledge or what knowledge that is to be obtained regarding health is not stated in any way, this is the teacher's job to figure out. This knowledge shall be the same regardless of where you live, this could prove to be a problem as different teachers interpretation of health will reflect the pupils knowledge of their own health. This work points out some of the problems that can arise due to the complexity of the concept of health as there are no guidelines in the curriculum that could be of help for teachers'. Through interviews with active physical education teachers and questionnaires for their pupils this work illustrates several aspects of problems most likely occurring in school regarding the health education..

ABSTRACT. Introduction: In the Swedish government?s public health policy the municipalities are emphasized as one of the most important actors. Based on their broad range of operations the municipalities have good opportunities to influence the health situation of its citizens. Aim: The purpose of this study is to investigate how the local public health coordinators in Region Västra Götaland are working and what barriers they experience in their work.

Background: The need for palliative care at home hasincreased in recent years as more people wish to die in their own homes. Toperform good palliative care by addressing patients' needs and desires of lifecare requires a better understanding of how nurses experience palliative careat home. Aim: The aim of the study was todescribe nurses experiences of caring for patients in palliative care in homecare. Method: The method was asystematic literature review and the article search resulted in elevenqualitative articles. An inductive qualitative approach was used where nursesdifferent experiences was identified. Results: Our results are reportedunder two themes:Opportunities and Barriers. Palliative carein home care experiencedby nurses in variousways in which personalgrowth, experience, guidance,trustful communication, cooperation and self-knowledgewas opportunies thatemerged. Barriers experienced by nurseswas ineffective communication,lack of time and abuseof power in palliative care at home.

Discussion about the connection between severe mental disorders and criminal acts is constantly ongoing. Violent crimes committed by persons with severe men-tal disorders get a lot of media attention in today´s society. This arise general questions regarding the penalties that these offenders are sentenced to. It is known that the responsibility for these people lies on the forensic psychiatry, however, the media does not draw attention to what is happening in this organization. The purpose of this study is to describe the forensic psychiatric organization from a staff perspective and from a legal perspective.

Background: Prediabetes is caused by relative insulin deficiency and insulin resistance in the body tissue which leads to abnormal blood glucose levels. Prediabetes can over time lead to type 2 diabetes mellitus. To prevent the onset of type 2 diabetes and its complications, it is important to identify early elevated blood glucose levels and thereby prediabetes.Objective: To describe nurses' knowledge and experience regarding the management of patients with prediabetes.Methods: Qualitative descriptive design with individual interviews. Three nurses, three community health nurses and three diabetes nurses were interviewed.Results: The result can be understood from the nurses' experiences of encountering patients with prediabetes. An overarching theme in the analysis was that the nurses are working or aspiring to work preventively.

The annual cost of home care services of transport in Falun/Borlänge, is now at 31 million kronor. It is clear from previous research that it is possible to reduce these costs through a restructuring of the existing home-help service. The restructuring aims to have a higher proportion of older people, who are in need of care, to live in special accommodation, in order to reduce transport costs. Therefore there is a need for systems that allow home-help service to plan their operations in such a way that transport is working as efficiently as possible. Through better planning, there are profits to be done.