The aim of this thesis is to study Stadshuskällaren?s operational processe flow and identify their operational characteristics. The uniqueness of Stadshuskällaren is that they are breaking the law of trade-offs regarding volume/variety, much like Toyota managed to do ? which spawned the entire field of research of the ?Lean Philosophy?. In the thesis the characteristics we identify through analysis, which enables Stadshuskällaren to break the trade-off, are compared with the principles of Lean service theory, which ultimately stem from Toyota.

Previous research and patient complaints to the Swedish Patient Support Committee shows that there is a lack of substance in the patient-nurse relationship. This may suggest that it can be difficult for health care to live up to health-care law which requires it to be of good quality, based on dignity and respect and designed so that the patient is an active participant and can make their own decisions when it comes to their health care. For a better understanding of what a dignified patient-nurse relationship is, this study aims to clarify what the patient values as good patient-nurse relationship and describe how they have experienced the patient-nurse relationship during their stay at an emergency care department. The study is a descriptive cross-sectional study with a quantitative approach, where the population consisted of patients who were cared for at an emergency care department in the County of Västmanland, Sweden during 2007. The sample consisted of 93 patients which were asked to answer a questionnaire.

Bakgrund: Under de senaste decennierna har den offentliga svenska sjukvården genomgått stora förändringar. Ett av de begrepp som implementeras är Lean Healthcare. Begreppet bör ses som en filosofi och strategi. Verksamhetsstyrningen bör anpassas efter vald stra-tegi, som exempelvis Lean Healthcare. Det finns dock inte en universell metod för hur styrningen bör anpassas efter Lean Healthcare, utan styrningen bör vara individuellt anpas-sad.Syfte: Syftet med denna studie är att genom att studera sex sjukhus utreda hur sjukhusens verksamhetsstyrning stödjer strategin Lean Healthcare.Metod: Vi uppfyllde vårt syfte genom att göra en multipel fallstudie på sex sjukhus tillhö-rande två landsting, Skåne och Jönköping Vi har intervjuat personer med olika befattningar på sjukhusen för att skapa oss en uppfattning om hur Lean Healthcare stöds i sjukhusens verksamhetsstyrning.

Background: It is required that health care professionals continuously work with patient safety and quality improvements, and the skills of registered nurses are significant in this work. However, quality improvement also requires commitment and knowledge about how to improve health care and ensure patient safety. There is a lack of studies that highlights the importance of supportive functions for this work. Nurses in clinical settings can be utilized as facilitators that make things easier for other health care professionals who are engaged in quality improvement and patient safety. In order to gain understanding about the significance and needs of nurses with a role of facilitator, it is urgent to learn from their experiences of facilitating quality improvement in health care.Aim: The aim was to study nurses? experiences of facilitating quality improvement of nursing care, patient safety and multi-professional collaboration in health care.Method: Semi-structured qualitative interviews were performed with ten registered nurses who had experience of being in the role of facilitators.

Den svenska planprocessens effektivitet är ett problematiskt och omdiskuterat ämne. Uppsatsen behandlar effektivisering av den fysiska planeringsprocessen med leanteoretiska begrepp som utgångspunkt. På senare tid har flera alternativa lösningar för effektivisering uppkommit. En av dessa lösningar är lean, en verksamhetsstrategi med ursprung från Toyotas produktionsfilosofi. Uppsatsen utgår ifrån en kvalitativ forskningsmetod med målet att genom intervjuer, offentliga rapporter och litteratur granska den svenska planeringsprocessen och fenomenet lean inom fysisk planering.

ABB Capacitors Ludvika started their LEAN-project in november 2010, but still has not the whole factory been introduced to the LEAN-tool called 5S. 5S is only implemented on the ?easiest? work-areas.By implementing 5S, at the workingstation called inburkningen, would make the workstation and the area around it much more structured, clean and systematized. The operators are a little bit skeptical to the work that includes continuous improvement today, because they can not see any progresses. If 5S were implememted the operators would be able to avoid searching for tools because with 5S, each tool will have a specified place at the workstation.5S would simplify the cooperation between the shifts, because 5S includes clear instructions for how the workstations will be cleaned after each shift.This report will include my recommendations, thoughts and opinions regarding however ABB Capacitors Ludvika should implement or not implement the LEAN-tool 5S.

ABSTRACT The aim of this thesis is to illustrate how surgical operation theatre nurses perceive debriefing within emergency health care. The study has a qualitative design with semi structured interviews that have been performed with seven operating room nurses working in emergency health care. The strategic selection consists of professional operation theatre nurses working in emergency care at Uppsala University Hospital. The main goal of this thesis is to increase the understanding of debriefing and to highlight the need of debriefing after difficult or unexpected events in the emergency health care profession.The interviewed nurses perceive debriefing as an important way to develop the day to day work, but also as a way to unburden the staff at the time of bigger traumas. Even though the effect of debriefing is not univocally positive in the literature, the staff perceives that it reduces different kinds of stress.

Bakgrund Lean är en managementmetod från privata näringslivet med ursprung från Toyotas bilproduktion i Japan och är både en filosofi om ständiga förbättringar mot perfektion och en metodik. Allt fler offentliga organisationer väljer att ta till sig Lean-modellen varför forskning inom området är ett aktuellt ämne.SyfteSyftet med denna uppsats är att besvara tre frågor:1. Varför väljer vissa kommuner/verksamheter att tillämpa Lean?2. Hur implementeras Lean, och i vilken grad sker anpassningen till lokala förutsättningar?3. Finns det några faror förbundna med Lean?MetodFörutom vetenskaplig litteratur har fallstudier bedrivits vid två offentliga verksamheter som arbetar med Lean; Äldreomsorgen inom Vara Kommun och synverksamheten i Borås vid Västra Götalandsregionen. Intervjuer, tolkning av dokument och observationer har använts.ResultatVald teori för uppsatsen visar att de bakomliggande skälen för politiker och makthavare att införa Lean kanske mera handlar om att erbjuda verksamheten ett skyltfönster av framgång (Legitimitet!) än att ta i tu med utmaningarna i verksamheten. En annan bidragande orsak till att införa Lean kan vara den omvända bevisbördan ? att en organisation som inte har Lean får förklara varför man inte har det.Det finns risker med Lean.

Today is what you could call a golden age for technological development in health care. Technology is given a bigger role in healthcare and serves not only as a support for health professionals in their daily work but also as a tool for the patient. With the help of eHealth services, patients are becoming more involved in their own care. This improves patient?s knowledge about their health, which in turn contributes to higher motivation to perform self-care.

The Production Manager at Atlas Copco AB Craelius wants to adopt a lean approach to become more competitive. This thesis is an exploratory study of the subject and what it means for the business activity and its implementation process.The objective is to provide a basic understanding of lean to the company, and what this means for Atlas Copco AB Craelius. The report describes the industrial revolution in brief. This is because the company itself must understand where certain ways of looking at production management is derived from. Furthermore, it provides an understanding of Lean's origins.

Background: Female circumcision or female genital mutilation is a tradition that is carried out mainly in Africa. The intervention refers to that part of- or all of the girl?s external genital organs are removed. Aim: The study's purpose was to highlight the consequences of female circumcision in the encounter with western health care.Method: A systematic literature reviews was performed as a method. Twelve articles were selected for the study and these were sought in Chinal, PubMed and PsycINFO. Analysis and interpretation was done according to qualitative content analysis, inspired by Lundman and Granheim.

Background: Mental illness is a growing public health problem which can cause significant disabilities and lead to poor quality of life. As primary care nurses often are the first to encounter these patients they need knowledge to be able to respond appropriately to this group.Aim: The aim was to describe how the sufferer of mental illness experiences the introduction to primary care. Method: The literature review was based on the results of 11 scientific articles which were analyzed with the inspiration of a metasynthesis method.Results: Four categories emerged: the experience of being treated like a human being, the importance of a therapeutic space, the experience of time and availability as well as the importance of competent personnel and the importance of continuity. Patients described different aspects deemed important when encountering nursing staff. Conclusion: Patients experienced that they received good care when they felt listened to and seen as individuals with their own thoughts and feelings.

The workplace has a direct impact on the physical, psychological, economic and social well-being of the workers. A healthy workplace leads to increased health among the employees which also makes the employees more productive (Källestål, 2004). A poor working environment can have negative consequences for individuals, companies and society (SOU, 2009:47).This is a qualitative study that investigates companies? view of health promotion and how they practice health promotion in working life. Five private and five public companies, with representatives from the management were interviewed.

Background Anesthesia-related deaths are common in dogs, especially in the postoperative period, in compare to humans. This study aims to describe and elucidate the qualities of the postoperative care for dogs in Sweden. Method To investigate the postoperative care, a qualitative study was made by interviewing personnel in the animal health care sector. The primary information from the interviews was analyzed in a qualitative manor and a few distinguished qualities came forth. Results These qualities describe the postoperative care and include preventive activities, postoperative activities, monitoring and communication. A variation in regards to the results was seen between the interviewed.

Denna utvärdering ämnar svara på om arbetssättet Lean har minskat stressen, ökat stödet och ökat effektiviteten hos medarbetarna i en enhet hos Försäkringskassan. En webenkät har använts för att samla in den empiri som har analyserats. Slutsatserna visar på att medarbetarna anser att Lean i begränsad utsträckning har minskat stressen, delvis ökat stödet i deras arbete och i mindre utsträckning ökat deras effektivitet..