Nordin Annika Maria Margareta, Andersson Gäre Boel, Andersson Ann-Christine
The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University , Jönköping, Sweden and Qulturum, Region Jönköping County, Sweden.
The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University , Jönköping, Sweden and Futurum Academy for Health and Care, Region Jönköping County, Sweden.
Leadersh Health Serv (Bradf Engl). 2018 Oct 1;31(4):398-408. doi: 10.1108/LHS-03-2017-0012. Epub 2018 Jan 11.
Purpose The purpose of this paper is to examine how external change agents (ECAs) engaged to disseminate a national quality register (NQR) called Senior alert nationwide in the Swedish health care and elderly care sectors interpret their work. To study this, sensemaking theories are used. Design/methodology/approach This is a qualitative inductive interview study including eight ECAs. To analyze the data, a thematic analysis is carried out. Findings Well-disseminated NQRs support health care organizations' possibility to work with quality improvement and to improve care for patient groups. NQRs function as artifacts that can influence how health care professionals make sense of their work. In this paper, a typology depicting how the ECAs make sense of their dissemination work has been developed. The ECAs are engaged in prospective sensemaking. They describe their work as being about creating future good results, both for patients and affiliated organizations, and they can balance different quality aspects. Originality/value The number of NQRs increased markedly in Sweden and elsewhere, but there are few reports on how health care professionals working with the registers interpret their work. The use of ECAs to disseminate NQRs is a novel approach. This paper describes how the ECAs are engaged in prospective sensemaking - an under-researched perspective of the sensemaking theory.
目的 本文旨在探讨受雇在瑞典医疗保健和老年护理部门全国范围内推广名为“高级警报”的国家质量登记册（NQR）的外部变革推动者（ECA）如何解读他们的工作。为研究此问题，采用了意义建构理论。
设计/方法/途径 这是一项定性归纳访谈研究，包括八位ECA。为分析数据，进行了主题分析。
研究结果 广泛传播的NQR支持医疗保健组织开展质量改进工作并改善对患者群体的护理。NQR作为人工制品，会影响医疗保健专业人员对其工作的理解。本文构建了一种类型学，描述了ECA如何理解他们的推广工作。ECA参与前瞻性意义建构。他们将自己的工作描述为为患者和附属组织创造未来的良好成果，并且能够平衡不同的质量方面。
原创性/价值 在瑞典和其他地方，NQR的数量显著增加，但关于使用登记册的医疗保健专业人员如何解读他们的工作的报告却很少。利用ECA来推广NQR是一种新颖的方法。本文描述了ECA如何参与前瞻性意义建构——这是意义建构理论中一个研究不足的视角。
