Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare
Abstract Background The introduction of new tools can bring unintended consequences for organizational routines. Cancer Patient Pathways (CPP) were introduced into the Swedish healthcare system in 2015 to shorten time to diagnosis and treatment. Primary healthcare (PHC) plays a central role since ca...
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ftdoajarticles:oai:doaj.org/article:5c6e7bbeddfa4e2caacc1e83a5d26748 2023-05-15T17:44:34+02:00 Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare Petter Fjällström Anna-Britt Coe Mikael Lilja Senada Hajdarevic 2022-01-01T00:00:00Z https://doi.org/10.1186/s12913-021-07348-6 https://doaj.org/article/5c6e7bbeddfa4e2caacc1e83a5d26748 EN eng BMC https://doi.org/10.1186/s12913-021-07348-6 https://doaj.org/toc/1472-6963 doi:10.1186/s12913-021-07348-6 1472-6963 https://doaj.org/article/5c6e7bbeddfa4e2caacc1e83a5d26748 BMC Health Services Research, Vol 22, Iss 1, Pp 1-12 (2022) Standardized patient pathways Cancer Organizations Routines Unintended consequences Adaption Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1186/s12913-021-07348-6 2022-12-31T10:40:05Z Abstract Background The introduction of new tools can bring unintended consequences for organizational routines. Cancer Patient Pathways (CPP) were introduced into the Swedish healthcare system in 2015 to shorten time to diagnosis and treatment. Primary healthcare (PHC) plays a central role since cancer diagnosis often begins in PHC units. Our study aimed to understand how PHC units adjusted organizational routines to utilizing CPPs. Method Six PHC units of varied size from both urban and rural areas in northern Sweden were included. Grounded theory method was used to collect and analyse group interviews at each unit. Nine group interviews with nurses and physicians, for a total of 41 participants, were performed between March and November 2019. The interviews focused on CPPs as tools, the PHC units’ routines and providers’ experiences with using CPPs in their daily work. Results Our analysis captured how PHC units adjusted organizational routines to utilizing CPPs by fusing existing practices with new practices to offer better quality of care. Specifically, three overarching organizational routines within the PHC units were identified. First, Manoeuvring diverse patient needs with easier patient flow, the PHC units handled the diverse needs of the population while simultaneously drawing upon CPPs to ease the patient flow within the healthcare system. Second, (Dis) integrating internal know-how, the PHC units drew upon internal competence even when PHC know-how was not taken into account by those driving the CPP initiative. Third, Coping with unequal relationships toward secondary care, the PHC units dealt with being in an unequal position while adopting CPPs instead further decreased possibilities to influence decision-making between care-levels. Conclusion Adopting CPPs as a tool within PHC units brought various unintended consequences in organizational routines. Our study from northern Sweden illustrates that the PHC know-how needs to be integrated into the healthcare system to improve the use of new tools as ... Article in Journal/Newspaper Northern Sweden Directory of Open Access Journals: DOAJ Articles BMC Health Services Research 22 1 |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Standardized patient pathways Cancer Organizations Routines Unintended consequences Adaption Public aspects of medicine RA1-1270 |
spellingShingle |
Standardized patient pathways Cancer Organizations Routines Unintended consequences Adaption Public aspects of medicine RA1-1270 Petter Fjällström Anna-Britt Coe Mikael Lilja Senada Hajdarevic Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
topic_facet |
Standardized patient pathways Cancer Organizations Routines Unintended consequences Adaption Public aspects of medicine RA1-1270 |
description |
Abstract Background The introduction of new tools can bring unintended consequences for organizational routines. Cancer Patient Pathways (CPP) were introduced into the Swedish healthcare system in 2015 to shorten time to diagnosis and treatment. Primary healthcare (PHC) plays a central role since cancer diagnosis often begins in PHC units. Our study aimed to understand how PHC units adjusted organizational routines to utilizing CPPs. Method Six PHC units of varied size from both urban and rural areas in northern Sweden were included. Grounded theory method was used to collect and analyse group interviews at each unit. Nine group interviews with nurses and physicians, for a total of 41 participants, were performed between March and November 2019. The interviews focused on CPPs as tools, the PHC units’ routines and providers’ experiences with using CPPs in their daily work. Results Our analysis captured how PHC units adjusted organizational routines to utilizing CPPs by fusing existing practices with new practices to offer better quality of care. Specifically, three overarching organizational routines within the PHC units were identified. First, Manoeuvring diverse patient needs with easier patient flow, the PHC units handled the diverse needs of the population while simultaneously drawing upon CPPs to ease the patient flow within the healthcare system. Second, (Dis) integrating internal know-how, the PHC units drew upon internal competence even when PHC know-how was not taken into account by those driving the CPP initiative. Third, Coping with unequal relationships toward secondary care, the PHC units dealt with being in an unequal position while adopting CPPs instead further decreased possibilities to influence decision-making between care-levels. Conclusion Adopting CPPs as a tool within PHC units brought various unintended consequences in organizational routines. Our study from northern Sweden illustrates that the PHC know-how needs to be integrated into the healthcare system to improve the use of new tools as ... |
format |
Article in Journal/Newspaper |
author |
Petter Fjällström Anna-Britt Coe Mikael Lilja Senada Hajdarevic |
author_facet |
Petter Fjällström Anna-Britt Coe Mikael Lilja Senada Hajdarevic |
author_sort |
Petter Fjällström |
title |
Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
title_short |
Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
title_full |
Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
title_fullStr |
Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
title_full_unstemmed |
Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
title_sort |
merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
publisher |
BMC |
publishDate |
2022 |
url |
https://doi.org/10.1186/s12913-021-07348-6 https://doaj.org/article/5c6e7bbeddfa4e2caacc1e83a5d26748 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_source |
BMC Health Services Research, Vol 22, Iss 1, Pp 1-12 (2022) |
op_relation |
https://doi.org/10.1186/s12913-021-07348-6 https://doaj.org/toc/1472-6963 doi:10.1186/s12913-021-07348-6 1472-6963 https://doaj.org/article/5c6e7bbeddfa4e2caacc1e83a5d26748 |
op_doi |
https://doi.org/10.1186/s12913-021-07348-6 |
container_title |
BMC Health Services Research |
container_volume |
22 |
container_issue |
1 |
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1766146822116474880 |