Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Health and Welfare, Dalarna University, Falun, Sweden.
J Health Organ Manag. 2024 Jul 19;38(9):258-279. doi: 10.1108/JHOM-04-2023-0111.
A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme.
DESIGN/METHODOLOGY/APPROACH: A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants.
Important factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme's intention.
ORIGINALITY/VALUE: The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case.
一家为瑞典 288000 名居民提供医疗服务的当地医疗机构长期面临预算赤字问题。该机构曾多次试图扭转严峻的财务状况，但均以失败告终。于是该机构启动了一项退役计划，两年后，评估结果显示收效良好。本研究旨在探讨政治家和公务员认为对项目成功实施有促进作用的因素。
设计/方法/途径：采用了一种演绎内容分析方法，使用了促进退役决策成功实施的因素框架，对 18 名受访者进行了访谈分析。
重要因素包括：（1）一份有助于证据清晰的审查报告，使变革理由的清晰性不容置疑，并（2）增强了对变革的政治支持。其他因素还包括：（3）强有力的行政领导，（4）得到（5）高质量项目管理支持的临床领导力，以及（6）被视为前进道路上重要成果的文化和行为变革。要最大限度地提高大规模退役计划成功实施的潜力，就需要建立一个共享的愿景，并以令人信服的证据为基础进行合作。让具有临床背景的公务员加入行政领导团队，为退役计划的意图提供合法性、能力和信任。
原创性/价值：本文探讨了退役流程最佳实践的知识有限的问题，并提供了一个成功案例的经验知识。
