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BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway

Authors: Trond Kongsvik, Kristin Halvorsen, Tonje Osmundsen, Gudveig Gjøsund

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

Patient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories.

Methods

A qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel.

Results

The LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers.

Conclusions

As a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.
Literature
1.
European Commission. Patient safety and quality of care (Special Eurobarometer 411): European Commission, Directorate for Health and Consumers. 2014.
2.
Deilikås ET. Rapport for Nasjonal Journalundersøkelse med Global Trigger Tool 2013 [Report from the Norwegian National Medical Record Review Using Global Trigger Tool in 2013]. The Norwegian Knowledge Centre for the Health Services: Oslo; 2014. In Norwegian.
3.
Runciman W, Hibbert P, Thompson R, Van Der Schaaf T, Sherman H, Lewalle P. Towards an international classification for patient safety; key concepts and terms. Int J Qual Health Care. 2009;21:721–38.CrossRef
4.
Foundation H. Evidence scan: Levels of harm in primary care. London: Health Foundation; 2011.
5.
Ministry of Health and Care Services. Pasientsikkerhetsprogrammet I trygge hender 24–7. Strategi 2014–2018. [The patient safety program In Safe Hands 24–7. Strategy 2014–2018]. Oslo: Ministry of Health and Care Services; 2013. In Norwegian.
6.
Kodner D, Spreeuwenberg C. Integrated care: meaning, logic, applications, and implications-a discussion paper. Int J Integrated Care. 2002;2.
7.
Ministry of Health and Care Services. Fra stykkevis til helt. En sammenhengende helsetjeneste [From fragmentation to integration. Coherent health services]. Oslo: Ministry of Health and Care Services; 2005. In Norwegian.
8.
Ministry of Health and Care Services. High Quality-Safe Services-Quality and Patient safety in the Health and Care Services. Oslo: Ministry of Health and Care Services, 2010–2011.
9.
10.
Stelfox HT, Palmisani S, Scurlock C, Orav EJ, Bates DW. The “To Err is Human” report and the patient safety literature. Qual Saf Health Care. 2006;15(3):174.CrossRefPubMedPubMedCentral
11.
Johannessen AK, Lurås H, Steihaug S. The role of an intermediate unit in a clinical pathway. Int J Qual Health Care. 2013;13:2.
12.
Dahl UA, Steinsbekk A, Jenssen S, Johnsen R. Hospital discharge of elderly patients to primary health care, with and without an intermediate care hospital-a qualitative study of health professionals’ experiences. Int J Qual Health Care. 2014;14:2.
13.
Krasnik A, Paulsen B, JM V. Reforming primary health care. In: Saltman RB K, editor. Nordic health care systems Recent reforms and current policy challenges European Observatory on Health Systems and Policies Series. Berkshire: McGraw-Hill; 2009. p. 233–54.
14.
Mamen K, Nylenna M. Sykestuene i Norge. En skjult ressurs som bør integreres i fremtidens sykehjem? [Community hospitals. A hidden resource to be integrated in the future nursing home?]. Tidsskrift for Den Norske Legeforening. 1987;107:2657–60. In Norwegian.PubMed
15.
Aaraas I, Langfeldt E, Ersdal G, Haga D. Sykestuemodellen, nøkkel til bedre samhandling i helsetjenesten-la sykestuene leve! [The community hospital model, a key to better collaboration in health care]. Tidsskrift for Den Norske Legeforening. 2000;120(6):702–5. In Norwegian.PubMed
16.
Ministry of Health and Care Services. Nasjonal helse-og omsorgsplan: 2011–2015 [National plan for health and care]. Oslo: Ministry of Health and Care Services; 2011. In Norwegian.
17.
Romøren TI, Torjesen DO, Landmark BF. Promoting coordination in Norwegian health care. 2011.
18.
Bredeli E, Jensen A. Samhandlingsreformen : kartlegging av data om lokalmedisinske sentre [The Coordination reform: Mapping of local medical centres]. Statistisk sentralbyrå: Oslo; 2012. In Norwegian.
19.
Greenwood R. Handbook of organizational institutionalism. Handbook of organizational institutionalism. Los Angeles: Sage; 2008.
20.
Scott WR, Ruef M, Mendel PJ, Caronna CA. Institutional change and healthcare organizations: From professional dominance to managed care. Chicago: University of Chicago Press; 2000.
21.
Meyer JW, Rowan B. Institutionalized organizations. Formal structure as myth and ceremony. Am J Sociol. 1977;83(2):340–63.CrossRef
22.
Zucker LG. Production of trust. Institutional sources of economic structure. 1840–1920. Res Organ Behav. 1986;8:53–111.
23.
Turner BA, Pidgeon NF. Man-made disasters. Oxford: Butterworth-Heinemann; 1997.
24.
Rosness R, Grøtan TO, Guttormsen G, Herrera IA, Steiro T, Tinmannsvik RK, et al. Organisational accidents and resilient organisations: six perspectives. Rev. 2. Trondheim: SINTEF, Technology and Society, Safety Research; 2010.
25.
Kripalani S, Lefevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians: Implications for Patient Safety and Continuity of Care. JAMA. 2007;297(8):831–41.CrossRefPubMed
26.
Dekker S. Patient safety: a human factors approach. Boca Raton: CRC Press; 2011.CrossRef
27.
Lenburg CB, Klein C, Abdur-Rahman V, Spencer T, Boyer S. The COPA model: a comprehensive framework designed to promote quality care and competence for patient safety. Nurs Educ Perspect. 2009;30(5):312.PubMed
28.
Ginsburg LR, Tregunno D, Norton PG. Self-reported patient safety competence among new graduates in medicine, nursing and pharmacy. BMJ Qual Saf. 2008;22:147–54.CrossRef
29.
Gautun H, Syse A. Samhandlingsreformen. Hvordan tar de kommunale helse- og omsorgstjenestene i mot det økte antallet pasienter som skrives ut fra sykehusene? [The Coordination Reform: How are the increasing number of patients discharged from hospitals received by primary care?] 2013. [In Norwegian].
30.
Lovdata. Forskrift om systematisk helse-, miljø-og sikkerhetsarbeid i virksomheter (Internkontrollforskriften). [Regulation on systematic work on health, environment and safety in enterprises (the Internal control regulation)]. Oslo: Arbeidsdepartementet; 1996. In Norwegian.
31.
Deming WE. Out of the crisis: quality, productivity and competitive position. Cambridge: Cambridge University Press; 1986.
32.
Saksvik PØ, Torvatn H, Nytrø K. Systematic occupational health and safety work in Norway: a decade of implementation. Saf Sci. 2003;41(9):721–38.CrossRef
33.
Silverman D. Doing qualitative research. 3rd ed. Thousand Oaks: SAGE Publications; 2009.
34.
Luz K, Redergård A, Kulseng B. Diabetessykepleier i distriktene. Evalueringsrapport basert på 11 intervju med involverte helsepersonell og brukere av tilbudet. [District diabetes nurses. Evaluation report based on 11 interviews of health personnel and users of the services]. Trondheim: Centre of Obesity; 2014. In Norwegian.
35.
Perrow C. Normal accidents living with high-risk technologies. Princeton: Princeton University Press; 1999.
36.
LaPorte TR, Consolini PM. Working in practice but not in theory: Theoretical challenges of “High-Reliability Organizations”. J Public Adm Res Theory. 1991;1(1):19–48.
37.
38.
39.
Amalberti R, Benhamou D, Auroy Y, Degos L. Adverse events in medicine: Easy to count, complicated to understand, and complex to prevent. J Biomed Inform. 2011;44(3):390–4.CrossRefPubMed
Metadata
Title
Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway
Authors
Trond Kongsvik
Kristin Halvorsen
Tonje Osmundsen
Gudveig Gjøsund
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1708-8

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