Previous research and theory suggests that frontline workers adapt to workload-related stress in a number of ways, interacting towards or away from citizens, or even against citizens, but what are the actual practices of coping, and how is coping related to stress? The data comes from a web-survey sent to 990 public sector frontline workers in West Sweden during 2018 within the police, health care psychiatry, and social work organizations. The findings show that there are significant differences in stress: highest average level among social workers, followed by police officers, and heath care psychiatry. Four ways of moving towards clients – through prioritizing motivated clients, rule bending/breaking, instrumental action, or using personal resources – and three ways of moving away from clients – through aggression, by rationing, or routinizing – are revealed (H1). Prioritizing and aggression are most common within the police, rule bending/breaking and routinizing in social work, and instrumental action within health care (H2), but only instrumental action does not significantly increase stress, on top of individual characteristics and organizational demands and resources (H3).

OBJECTIVE: To examine the impact of a simulation training in raising a group of young students' personal and situational awareness in disasters and emergencies.

METHODS: In total, 25 young students participated in two simulation scenarios representing two actual events, fire, and shooting, using a combination of two validated simulation training (Emergency Management and Preparedness Training for Youth [EMPTY]). The changes in their knowledge and awareness were evaluated by using questionnaires and the whole simulation was evaluated by three independent observers and a reference group.

RESULTS: New concepts of emergency management, for example, evacuation, and barricading, could be trained in a safe environment. There was a significant increase in students' personal and situational awareness and their active engagement in the management of emergencies.

CONCLUSION: EMPTY could raise the youth basic knowledge and ability to understand the concept of preparedness by being mentally prepared, available for collaboration, gaining a higher confidence, understanding the physical and psychological consequences of a major incident and the importance of their own safety. (Disaster Med Public Health Preparedness. 2018; page 1 of 4).

An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

Den här studien handlar om interorganisatorisk samverkan inom vård och omsorg. Här studeras vilka strategier som första och andra linjens kommunala chefer använder för att få till stånd en fungerande samverkan. Hur ser hindren ut och vilka strategier och överväganden gör cheferna för att övervinna dem. Den fråga som därför behandlas i denna rapport är; vilka strategier an-vänder kommunala chefer inom vård och omsorg för att implementera samverkan? I studien har data samlats in genom att 21 chefer inom vård och omsorg intervjuats. De chefer som medverkat i studien har alla varit verksamma i kommuner som deltagit i det Nationella kommunforskningsprogrammet, vilka är Borås, Göteborg, Lund, Norrköping, Piteå, Sjöbo och Stockholm. I studien har tre centrala iakttagelser gjorts. Dessa handlar om; 1) att cheferna väljer en form av situationsanpassad strategi beroende på vad sam-verkan har för syfte och med vilka aktörer som samverkan ska genomföras, 2) att cheferna behöver hantera den upplevda intressekonflikten som finns mellan att ta ansvar för den "egna verksamheten" samtidigt som de förväntas ta ansvar för samverkan med andra organisationer och 3) att cheferna har svårt att hantera sitt chefsansvar vid samverkan. Samverkan där linjestyrningen utmanas eller kompletteras med horisontell styrning är lösare reglerad vilket kan leda till oklar ansvarsfördelning och diffus arbetsdelning. Här kan chefer behöva tillägna sig andra uttryck för att utöva sitt ledarskap då den traditionella chefsrollen inte är lika väl anpassad till styrning vid samverkans-situationer.

Team är populära, inte minst inom vård, behandling och omsorg.Trots att det börjar bli en väl etablerad företeelse tycks teamfortfarande stå för förnyelse och nytänkande. Teamarbete harsåledes kommit att få en allt viktigare roll.

I denna antologi behandlas frågor som: Varför uppstår team? Vadgör team nödvändiga? Vad är utmärkande för olika typer av team? Vad skapar väl fungerande team? Vilka effekter får teamarbete förverksamheten? Du som läsare bjuds på både kritiska betraktelser,utvecklingsspår och verktyg.

Boken vänder sig till studerande och forskare vid högskolor ochuniversitet samt till praktiskt verksamma inom vård-, behandlingsochomsorgsorganisationer. De olika kapitlen kan läsas friståendeoch ger var för sig en god bild av teamets funktion.

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Team i vård, behandling och omsorg förmedlar en unikinsikt och förståelse kring teamarbetes betydelse, funktionssätt och utmaningar baserad på omfattande och mångårig forskning. Boken förtjänar därför attanvändas inom alla utbildningar på högskolenivå som är inriktade mot vård- och omsorg.

Stefan Tengblad, professor i företagsekonomi

The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.

This article aims to study whether exercises contribute to learning that can be useful in actual emergency work. It reports the findings of a study about professional emergency personnel’s perceptions of the impact of collaboration exercises. Surveys were distributed and collected from emergency personnel in conjunction with three collaboration exercises that took place in Sweden in spring 2012. The survey included personnel holding different positions within the police department, fire department and ambulance services. Among them were also operational personnel such as officers. A total of 94 professional emergency personnel agreed to participate by answering the survey. The response rate was 95%.The study shows that collaborative elements in exercises contribute to perceived learning (R2 = 0:53), and that learning, in turn, has a perceived beneficial effect on actual emergency work (R2 = 0:26).The perceived results of collaboration,learning and their impact on actual emergency work, however, are moderate.The exercises were characterised by long waiting times and gave few opportunities to practise different strategies. Only a few respondents felt that they learned something about the collaborating organisations’ ways of communicating and prioritising. Many also thought that the exercises were more useful for command officers than for operational personnel.Thus, the study shows that by strengthening the collaborative elements of the exercises, the perception of the participants’ actual emergency work can be developed.

This study identifies hidden artefacts in a public organisation. In contrast to earlier studies, itfocuses on artefacts as concealing rather than conveying meaning. Negligent behaviour causedby an unpopular culture was recognised in five psychiatric wards at a Swedish universityhospital. Data comprising observations (87 h) and interviews (n = 60) were collected over aperiod of 48months (2008–2011). Four different items used in everyday work representing adeeper meaning of the organisation were identified during the observations. The items selectedwere work attire, nametags, keys and restraint beds. These were considered particularly promisingwhen it came to the aim of the study, namely, to find out how artefacts are camouflaged. Theobservations and the interviews revealed that these were controversial and contested artefacts inthe organisation. The study uses the term ‘cultural camouflage’ for behaviour that ignores andconsciously conceals symbols that have negative values. This concept contrasts with previousresearch that shows how artefacts are emphasised and how they contribute to the character ofthe activity in a transparent way. Conservative and backward-looking behaviour among staffprovided one explanation as to why artefacts were concealed. Another was the need to establishharmonious internal interactions.