Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare
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 dia...
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Umeå universitet, Institutionen för omvårdnad
2022
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ftumeauniv:oai:DiVA.org:umu-191123 2023-10-09T21:54:32+02:00 Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare Fjällström, Petter Coe, Anna-Britt Lilja, Mikael Hajdarevic, Senada 2022 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-191123 https://doi.org/10.1186/s12913-021-07348-6 eng eng Umeå universitet, Institutionen för omvårdnad Umeå universitet, Sociologiska institutionen Umeå universitet, Allmänmedicin BMC Health Services Research, 2022, 22:1, orcid:0000-0003-3503-7164 orcid:0000-0003-1975-9060 orcid:0000-0002-5203-9877 orcid:0000-0003-0661-8269 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-191123 doi:10.1186/s12913-021-07348-6 PMID 34974839 ISI:000737069900003 Scopus 2-s2.0-85122161997 info:eu-repo/semantics/openAccess Adaption Cancer Grounded Theory Method Group interviews Organizations Primary care nurses Primary care physicians Routines Standardized patient pathways Unintended consequences Nursing Omvårdnad Article in journal info:eu-repo/semantics/article text 2022 ftumeauniv https://doi.org/10.1186/s12913-021-07348-6 2023-09-22T14:00:05Z 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 CPP. ... Article in Journal/Newspaper Northern Sweden Umeå University: Publications (DiVA) BMC Health Services Research 22 1 |
institution |
Open Polar |
collection |
Umeå University: Publications (DiVA) |
op_collection_id |
ftumeauniv |
language |
English |
topic |
Adaption Cancer Grounded Theory Method Group interviews Organizations Primary care nurses Primary care physicians Routines Standardized patient pathways Unintended consequences Nursing Omvårdnad |
spellingShingle |
Adaption Cancer Grounded Theory Method Group interviews Organizations Primary care nurses Primary care physicians Routines Standardized patient pathways Unintended consequences Nursing Omvårdnad Fjällström, Petter Coe, Anna-Britt Lilja, Mikael Hajdarevic, Senada Merging existing practices with new ones: the adjustment of organizational routines to using cancer patient pathways in primary healthcare |
topic_facet |
Adaption Cancer Grounded Theory Method Group interviews Organizations Primary care nurses Primary care physicians Routines Standardized patient pathways Unintended consequences Nursing Omvårdnad |
description |
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 CPP. ... |
format |
Article in Journal/Newspaper |
author |
Fjällström, Petter Coe, Anna-Britt Lilja, Mikael Hajdarevic, Senada |
author_facet |
Fjällström, Petter Coe, Anna-Britt Lilja, Mikael Hajdarevic, Senada |
author_sort |
Fjällström, Petter |
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 |
Umeå universitet, Institutionen för omvårdnad |
publishDate |
2022 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-191123 https://doi.org/10.1186/s12913-021-07348-6 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
BMC Health Services Research, 2022, 22:1, orcid:0000-0003-3503-7164 orcid:0000-0003-1975-9060 orcid:0000-0002-5203-9877 orcid:0000-0003-0661-8269 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-191123 doi:10.1186/s12913-021-07348-6 PMID 34974839 ISI:000737069900003 Scopus 2-s2.0-85122161997 |
op_rights |
info:eu-repo/semantics/openAccess |
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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1779318127654338560 |