I denna uppsats har jag studerat förändringsarbete i samband med införande av Lean Healthcare. Arbetet har en abduktiv ansats där jag utifrån en fallstudie på Akademiska Sjukhuset i Uppsala har studerat hur de arbetar med förändringsarbetet. För att få insikt i deras förändringsarbete har jag intervjuat delar av personalen och deltagit i två av deras utbildningsdagar.Förutom en beskrivning av hur arbetet på Akademiska Sjukhuset är organiserat så innehåller arbetet även en stor teoridel som tar upp de grundläggande principerna i Lean-filosofin. I tillägg till detta så presenteras också en modell för förändringsarbete och jag har tagit med teorier som specifikt handlar om förändringsarbete i samband med införande av Lean Healthcare. Genom att jämföra teorierna med erfarenheterna från utbildningsdagarna har jag sedan kunnat dra slutsatser om förändringsarbetet.För att lyckas med Lean-implementeringen är det viktigt att inse att det kan finnas ett motstånd mot förändringarna.

Lung cancer is a disease which patients experience stigma in society and in care. This is because lung cancer is often seen as a self-inflicted disease. The stigma surrounding lung cancer is due to the strong relationship with smoking and have been shown to have a negative impact on the perceived health. The purpose of this study was to illuminate experiences of stigma for patients with lung cancer. The literature review was based on 11 scientific articles.

Denna uppsats ämnar förklara och skapa förståelse för förutsättningar till Lean Healthcare, den metod för effektivisering som sjukvården anammat för att utveckla och förändra de traditionsenliga verksamhetsstrategier som länge styrt sjukvårdens arbetssätt och processer. Genom att identifiera vilka egenskaper som bör stimuleras hos framtida arbetskraft för att skapa de förutsättningar som krävs för att vidmakthålla Lean Healthcare som en långsiktig effektiviseringsmetod bidrar denna studie med information som är behövlig för att ihärdigt lyckas med Lean Healthcare.De svårigheter som påvisats vid implementeringen av Lean Healthcare kan från befintlig forskning härledas till en kollision mellan den organisationskultur som förespråkas inom Lean, ursprungskonceptet till Lean Healthcare och den kulturella kontext som finns inom befintlig organisationskultur där Lean implementeras. Denna kollision påvisas genom en avsaknad av ihärdighet inom organisationerna som implementerat Lean då befintlig organisationskultur och verksamhetsstrategi motsätter sig de arbetsprocesser och det arbetssättet som förespråkas inom Lean-filosofin. Då många sjukhus i Sverige redan implementerat, eller är under omstrukturering till att implementera, Lean Healthcare ämnar denna uppsats undersöka hur framtida arbetskraft förhåller sig till det arbetssätt som förespråkas inom sjukvården.Utifrån en positivistisk kunskapssyn och ett deduktivt angreppssätt genomfördes en kvantitativ studie där arbetssättet och lärandet undersöktes hos en grupp studenter inom sjukvårdsprogrammen vid Umeå universitet. Arbetssättet och lärandet undersöktes för att kunna urskilja värderingar och beteenden som kunde härledas till att förutsäga utfallet av en integration mellan ny arbetskraft och befintlig organisationskultur inom sjukvården.Studiens resultat visar att arbete inom team innefattar karaktärsdrag hos framtida arbetskraft som behöver stärkas vilket främst bör göras genom att stimulera befintliga och kompatibla egenskaper med Lean Healthcare, så som beslutstagande och förmågan att ta an en ledarroll.

Citizens? freedom of choice has been a subject of debate in Sweden for over 30 years. This study focuses on decision making processes among patients within the Swedish healthcare system. The main conclusions are that in contrast to how patients? freedom of choice is described within governmental bills and governmental inquires and reports, patients are not following the steps included in the rational model of decision making.

The subject of this study was to research whether or not different forms of employment contracts had any effect on self reported health. Whether or not any difference between these forms could be explained through the use of employee health care was also a given point of interest. To achieve this, data from the national Swedish institute of health (FHI) was used, with 6465 of the 12 166 that participated in the study. Logistic regression was the primary statistical method.Initial Chi2-analyzation found no significant difference between the two main employment forms present in Sweden. However, when the variables age, sex and level of education were held constant through logistic regression, a difference of odds at 22% between the two employment forms could be identified.

Approximately one third of all patients in primary care have a psychosocial component to their illness that requires adequate professional treatment. However, primary care is insufficiently prepared for these patients. The aim of this case-study was to evaluate a pilot project in primary care offering psychotherapy as a treatment alternative. The data collected includes 1) data from 352 referred patients regarding demographics, diagnosis, treatment duration and pre- and post health status, 2) a patient-satisfaction questionnaire and 3) interviews with six therapists and five medical doctors. The treated patients improved significantly and showed a high degree of satisfaction.

ABSTRACTBackgroundPostpartum depression (PPD) occurs in 10% of women who have recently given birth. Postpartum depression is treatable but unidentified and untreated it could lead to serious consequences. There are multiple instruments for screening available. The Edinburgh Postnatal Depression Scale is the most frequently used and is regarded as the best instrument. AimThe aim of this study was to analyze to what extent and how midwifes and primary care nurses identify mothers with symptoms of depression respectively PPD.

How is research and science being used in political debate? An idea analysis of the debate about försäkringsmedicinskt beslutsstöd (decision tool in healthcare security)This is a case study on different types of research use (utilization) The aim of this paper is to examine how the politicians make use of expertise and research in the parliamentary debate surrounding the decision tool in healthcare security (försäkringsmedicinskt beslutsstöd). The aim is also to find out to what extent different types of research use are present in this debate. In this case study the qualitative method of idea analysis is being used on the empirical material. The tool of analysis is based upon the theories of research use by Amara et al.

Background: A group severely affected by health issues, the experiences of homeless alcohol and drug abusers in the coverage of their medical care needs is not satisfactory. Aim: The aim of the study is to explore which factors experienced by homeless alcohol and drug abusers in Uppsala in regards to their living situation affected their health, their perception of access to healthcare, the character of treatment received and coping strategies used outside of the healthcare system. Method: Nine people who had experienced both homelessness and substance abuse problem were recruited for the study during their visit to Stadsmissionens facilities for the homeless. Data was collected through qualitative, semi-structured interviews including two women and seven men. Data was analyzed using qualitative content analysis according to Giorgi modified by Malterud.Results: Among homeless substance abusers interviewed experiences of unwelcoming and prejudiced healthcare were described.

International trade in services has increased over the past 30 years as a result of progress in information and communication technology, increased focus on services from the manufacturing sector and the establishment of trade associations.The international market for healthcare services, also referred to as medical tourism, is growing more and more. Patients increasingly seeking treatment at other countries healthcare systems because of long queues within their own country or because it exists better prices for the same care abroad. However, this type of service exports occurs at a limited extent in Sweden.The purpose of this study is to highlight and analyze the conditions for Swedish service companies to export healthcare services. This, includes the challenges and opportunities that exist to expand the exports of these services.The approach for this study has been in the form of interviews with two market actors and written responses, from the same interview guide, with three market actors. These market participants are the so-called Care companies which export healthcare services in various counties, and the membership organization Swecare who work with export promotion activities for its members in the Swedish healthcare sector.

ABSTRACTMy degree project has resulted in the improvement of the guidance in the dental center?s entrance. The patients will now find it easier to understand and find the environment?s various functions, which is the reception, registration, payment, and waiting rooms. Norrbottens läns landsting has a concept ?hälsofrämjande väntrum? that provides guidelines for how they want their patients to experience their waiting rooms.

Syfte: Syftet med uppsatsen är att analysera vilka faktorer som möjliggör och hindrar innovation bland sköterskor inom Lean Healthcare på Ortopeden 12, USiL. Metod: Studien genomförs i form av en kvalitativ fallstudie med iterativ ansats. Teoretiska perspektiv: Studien använder sig av vanligt förekommande teorier kopplade till innovation. Cultural Web används för att analysera avdelningens paradigm som jämförs med förutsättningarna för innovation. Teorier som tar upp olika aspekter som kan påverka innovation tas också upp.

The aim with the study is to find key factors relating to internal marketing and to improve the process between the operating organization and its customers. A qualitative study is carried out within an organization active in the Swedish healthcare. The qualitative approach is carried out by collecting empirical data through observations, personal interviews and group interviews.The Physiotherapy Clinic at the Karolinska University Hospital is in the focus of the empirical study. The study locates existing differences in perceptions and comes up with recommendations for actions to improve the process of organisations within the Swedish healthcare and their customers. The study's results are that internal marketing can bring a lot to service-selling organizations and that the organizations internal conditions are as important as the external ones.Communication appears to be a key factor for an organization that has applied internal marketing.

The aim of the thesis is to present a study of what works well and what does not work so well in today?s use of computers in primary care with a special focus on the use of computers in the management of referrals for consultation. In May 2009 a module for electronic consultation referrals was introduced in the computer system Cosmic at the University Hospital in Uppsala. Previously, the primary care units had to use two different systems for management of referrals. Referrals sent internally within primary care have been sent electronically while referrals to the University Hospital or other external units were sent on paper.

The discrepancy in the rights for healthcare between undocumented migrants and the citizen in Sweden is a prerequisite for the existence of Läkarkliniken. Because of the chosen patient group the clinic stands outside the regulations from the National Board of Health and Welfare. The aim of this study was, from an institutional perspective, to investigate how such a unique player is designed and where the influences to the design origin from. The task was conducted thorough a qualitative case study with base in depth interviews. High levels of isomorphism were observed between Läkarkliniken and the general healthcare, however differences were seen as well.