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  • 1.
    Alverbratt, Catrin
    et al.
    University West, Department of Health Sciences, Specialist Nursing programme.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    A new working method in psyciatric care: the impact of implementation2016In: International Journal of Public Administration, ISSN 0190-0692, E-ISSN 1532-4265, Vol. 40, no 3, 295-304 p.Article in journal (Refereed)
    Abstract [en]

    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.

  • 2.
    Andersson, Annika
    et al.
    University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska Akademin, Institutionen för vårdvetenskap och hälsa .
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Organisering av en fingerad verklighet: Om övningar mellan blåljusorganisationer2013In: Nordiske organisasjonsstudier, ISSN 1501-8237, Vol. 15, no 3, 34-64 p.Article in journal (Refereed)
    Abstract [en]

    This study aimed to elucidate exercise participants’ understanding of critical aspects of organizing and implementation of collaboration exercises with police, fire department and ambulance services. The focus is critical aspects in exercises that have, or are expected to have, bearing on the participants’ ability to learn. Collaboration exercises are used as a tool to reinforce and develop the preparedness for future incidents. The need for such exercises was usually advocated after critique to actions during largescale real-life incidents. The study had a qualitative approach and is based on phenomenographic analysis of interviews with participants from four exercises with different scenarios. The identified critical aspects of exercises were related to realism, acceptance for mistakes, exercise extent and aims and opportunities for joint discussions. The management of an accident can be described to a large extent depend on the organizations’ joint ability to adapt to the prevailing situation and to collaborate. For exercises to contribute to these abilities, they could benefit from shifting the focus to how to organize exercises that allow participants to test different decisions and actions, with less emphasis on the choice of scenario.

  • 3.
    Andersson, Annika
    et al.
    University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture. Sahlgrenska Academy at University of Gothenburg.
    Åhgren, Bengt
    Nordic School of Public Health, Göteborg, Sweden.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Managing boundaries at the accident scene: a qualitative study of collaboration exercises2014In: International Journal of Emergency Services, ISSN 2047-0894, Vol. 3, no 1, 77-94 p.Article in journal (Refereed)
    Abstract [en]

    Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.

    Design/methodology/approach Interviews with 23 participants from four exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis.

    Findings Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision-making.

    Originality/value The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.

  • 4.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Carlstrom, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Decision making within a community provider organization2010In: British Journal of Community Nursing, Vol. 15, no 12, 611-617 p.Article in journal (Refereed)
    Abstract [en]

    Aim: To explore community nurses' experiences of decision making within the community provider organization. Background: Recent changes in health care with an increasing number of patients being cared for outside of institutions can put considerable pressure on the nurse with respect to decision making. Methods: In-depth interviews were performed with 6 registered nurses in two communities. The interviews were analysed by means of phenomenological hermeneutics. Results: The community nurses' experiences of decision making were interpreted as spiders or octopuses, consultants and troubleshooters. The subthemes were; networking and structuring, responsibility, availability and knowledge, assessment power, information selection, avoiding rules and bypassing managers. In accordance with hermeneutical phenomenology, the findings were discussed and explained with reference to Ofstad's philosophy of freedom to make decisions. Conclusion: In their decision making, community nurses are committed to finding administrative solutions that satisfy patient needs.

  • 5.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Blåljusorganisationer på olycksplatsen: om samverkansminimering2009In: Offentlig sektor och komplexitet: om hantering av mål, strategier och professioner / [ed] Adolfsson, Petra & Solli, Rolf, Lund: Studentlitteratur , 2009, 59-79 p.Chapter in book (Other academic)
  • 6.
    Berlin, Johan
    et al.
    Institutionen för vårdvetenskap och hälsa, Göteborgs universitet.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Christensen, Tom (2005). Organisationsteori för offentlig sektor. 1. uppl. Malmö: Liber2007In: Statsvetenskaplig Tidskrift, ISSN 0039-0747, Vol. 109, no 4, 94-96 p.Article, book review (Other (popular science, discussion, etc.))
  • 7.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Dolda artefakters betydelse: -En kritisk studie av kulturella uttryck inom psykiatrin2010In: Nordiske organisasjonsstudier, ISSN 1501-8237, Vol. 12, no 2, 27-44 p.Article in journal (Refereed)
  • 8.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    From artefact to effect: the organising effects of artefacts on teams2010In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 24, no 4, 412-427 p.Article in journal (Refereed)
    Abstract [en]

    Purpose – Earlier studies have identified artefacts, but have only to a lesser degree looked at theireffects. The purpose of this paper is to investigate how artefacts contribute to organisation. Design/methodology/approach – A trauma team at a university hospital has been observed andits members interviewed. Findings – The trauma team showed itself to be rich on artefacts since it had strong internal drivingforces, high legitimacy, and tried to live up to high expectations from the outside. Its members were motivated to be in the forefront of trauma care. Through renewal, the team succeeded in maintaining demarcation. It also succeeded in systemising internal work tasks and made for itself a position in relation to the outside. The team's capacity, however, came to be limited by internal conflicts and battles for prestige. Practical implications – The study shows that informal logic has a strong influence on teams.Teamwork contributed to the development of organisational structure and motivation for the personnel. Originality/value – Earlier studies advocate the important role of artefacts in order to communicate, collaborate, negotiate or coordinate activities. The conclusion is that artefacts also have an organising and developing effect on teams in a fragmented and differentiated healthcare.

  • 9.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Health Sciences, Specialist Nursing programme. University of Gothenburg.
    Learning and usefulness of collaboration exercises: A study of thethree level collaboration (3LC) exercises between the police, ambulance andrescue services2015In: International Journal of Mass Emergencies and Disasters, ISSN 0280-7270, Vol. 33, no 3, 428-467 p.Article in journal (Refereed)
    Abstract [en]

    In this article, we studied collaboration exercises (3LC) between the rescue services, ambulance services, and police force, which were developed to enhance learning and usefulness. The exercises’ structure was based on identified deficiencies in previous collaboration exercises. The purpose was to test the exercise model in terms of learning and usefulness. Ten 3LC exercises were observed. A total of 65 semi-structured interviews were conducted (2011–2014) in connection with the exercises. The exercises contained across-boundary elements, seminars, and interactive documentation. The participants were given the opportunity to discuss, analyze, and critically reflect on their efforts. During the seminars, the individual actions were analyzed, which led to alternative strategies that were subsequently tested in a repeated exercise. Our results demonstrate that repetitive features and seminars during collaboration exercises promote learning toward an organic behavior and usefulness in the actual incident work.

  • 10.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Samverkan mellan blåljusorganisationer2011 (ed. 1)Book (Other academic)
    Abstract [sv]

    Samverkan mellan olika yrkesprofessioner på en olycksplats är komplicerat. Mycket på grund av att förväntningarna inte alltid överensstämmer med förutsättningarna. I boken problematiseras agerandet på olycksplatsen. Friktionen mellan yrkesprofessioner lyfts fram och olika beteendemönster diskuteras.I boken tar författarna samverkan från retorik till ett praktiskt redskap, något som är möjligt att konkretisera och utföra praktiskt i det dagliga arbetet. Boken utgör samtidigt en introduktion till övningstekniken 3-nivåsamverkan (3-NS).I den här boken bjuds på flera närgångna beskrivningar. Medarbetare från fältet berättar om sina erfarenheter av samverkan, hur den tillämpas, om vilka möjligheter som finns och vilka svårigheter som behöver hanteras.Boken riktar sig till alla som arbetar i eller i anslutning till blåljusorganisationer. Den kan med fördel användas som lärobok för universitets- och högskolestuderande som läser till yrken inom polis, räddningstjänst eller ambulanssjukvård. Boken passar också för vidareutbildning av redan yrkesverksamma. Den kan även med fördel läsas av forskare, tjänstemän och politiker med intresse för hur framtidens blåljusorganisationer ska ledas, organiseras och styras.

  • 11.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Samverkan på olycksplatsen: om organisatoriska barriäreffekter2009Book (Other academic)
  • 12.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska akademin.
    Samverkansövningar: Om lärande och nytta2015 (ed. 1)Book (Other academic)
    Abstract [en]

    This study relates to collaboration exercises, with particular focus on the full-scale exercises between the police, rescue services and ambulance. To succeed in a complex situation, it requires that the personnel’s ability to collaborate across organisations be developed and refined.

    The overall aim of this study was to examine how collaboration is practised and how exercises lead to learning and usefulness. A research summary was initially done in this study. Based on that, a number of key concepts were developed that proved helpful when we followed the Swedish collaboration exercises through interviews and observations. The collected analysis has since been the basis for the design of a new exercise model, 3LC, three-level collaboration. It is based on the experiences we have had in studies of traditional exercises.

    The 3LC exercises that were conducted consisted of two practical sessions and three seminars. Each session was followed by an evaluative seminar with the aim that participants themselves would reflect and develop their patterns of behaviour. The two practical sessions were identical. It gave the participants the opportunity to rehearse and methodically try new approaches. The first exercise session was carried out according to the procedures that normally apply and govern the actions at an actual event. The second exercise session was preceded by a self-critical seminar where participants themselves identified what could be improved for the next exercise session.

    The research project was carried out from 2011 to 2014. A total of 19 collaboration exercises were studied, including 16 full-scale exercises. A total of 97 interviews and 125 hours of observation were carried out in this study. A questionnaire (CLU instrument) was developed, which was answered by 272 exercise participants.

    The study shows that collaborative sessions in the exercises contributed to the participants learning more and having greater usefulness from the exercises. 3LC exercises were perceived to enhance learning by 26 per cent and usefulness by 17 per cent, compared with traditional exercises. Collaborative exercises are benefitted when participants analyse their weaknesses themselves. Repetitive elements where participants try out alternative strategies improve preparedness prior to actual events.

  • 13.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    Sjuksköterskan som chef och ledare: en utmaning2017In: Pedagogik för sjuksköterskor / [ed] Håkan Sandberg, Lund: Studentlitteratur, 2017, 1, 295-313 p.Chapter in book (Refereed)
  • 14.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    The yellow line:  a critical study of the symbolic value of artefacts in health care teams2010In: Cognition, Technology & Work, ISSN 1435-5558, E-ISSN 1435-5566, Vol. 12, no 4, 251-261 p.Article in journal (Refereed)
    Abstract [en]

    Artefacts reveal an organisation's ''inner life'' and they contribute to its image and reputation. They also play a decisive role for an organisation's development. In this article, similar artefacts from two different health care teams—a trauma team and a psychiatric team—in the same hospital, are compared. The team members were interviewed and their work observed over the course of several years. It was demonstrated that identical pieces of equipment in a trauma team and a psychiatric team signalled opposite values. The psychiatric team was backwardlooking, conservative and contradictory. Modern technology and pieces of equipment were associated with an abandoned and previously criticised activity. The corresponding equipment in the trauma team, on the other hand, signalled a forward looking, developing and unified culture. The trauma team was a relatively new and powerfully idealised phenomenon, which attracted attention. The analysis points out how the symbolic values signal that one activity is attractive and pleasing while another has a low external legitimacy. 

  • 15.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Traumateam - förenklat flöde eller försvårande hinder?2006In: Hälso- och sjukvårdens ekonomi och logistik (HEL), Göteborg: Sahlgrenska akademin vid Göteborgs universitet , 2006, 202-209 p.Chapter in book (Other academic)
  • 16.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin. University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Vad övas vid samverkansövningar: - om första initiativeffekt och parallellitet2008In: Nordiske organisasjonsstudier, ISSN 1501-8237, no 4, 23-39 p.Article in journal (Other academic)
  • 17.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture.
    Why is collaboration minimised at the accident scene?: A critical study of a hidden phenomenon2011In: Disaster Prevention and Management, ISSN 0965-3562, Vol. 20, no 2, 159-171 p.Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to study why collaboration among police, fire, and ambulance services is minimised at accident scenes. Design/methodology/approach - Observations and semi-structured interviews were carried out during 2007-2008. The data material comprises a total of 248 hours of observations on 20 occasions and 57 interviews with 80 people.Findings - The study identifies the difference between rhetoric and practice in connection with accident work. Collaboration is seen as a rhetorical ideal rather than something that is carried out in normal practice. Asymmetry, uncertainty and lack of incentives are important explanations as to why only limited forms of collaboration are actually implemented.Research limitations/implications - The paper shows a distinction between collaboration as rhetoric and practical collaboration at accident scenes. Practical implications The article proposes a multi-faceted collaboration concept. In this way, collaboration can be developed and refined.Originality/value - The results of the study show that police, fire, and ambulance services want to develop excellent forms of collaboration at the accident scene, but avoid this as it leads to uncertainty and asymmetries and because of a lack of incentives. However, simpler forms of collaboration may be realistic in the organisation of everyday work at accident scenes. 

  • 18.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Blåljusövningar och lärande: - en ny typ av samverkansövning2011Conference paper (Refereed)
  • 19.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska Akademin, Institute of Health and Care Sciences.
    The Three-Level Collaboration Exercise: Impact of Learning and Usefulness2015In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 23, no 4, 257-265 p.Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to examine the emergency personnel’s perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other’s tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasi-experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).

  • 20.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sandberg, Håkan S.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Typifiering eller normering?: En kritisk studie av teamteoretiska modeller2009In: Företagsekonomisk ämneskonferens 2009: Företagsekonomin i samhället: forskning, ulbildning, relevans 11-12 november 2009, 2009, 1-15 p.Conference paper (Refereed)
    Abstract [sv]

    I den här studien fokuseras den starka passion som finns för typologier inom teamforskningen. Det finns typologier av teamprocesser, strukturella teamtyper och modeller för implementering av teamarbete. Vid första anblicken kan man i vissa fall få intrycket av att modellerna utvecklats utan att vara baserade på empiriska fynd och i andra fall att modeller blir en sorts självuppfyllande profetior som döljer möjligheten att urskilja variationer ur empiriska fynd.

    Syftet med denna artikel är att granska samband mellan ett antal typologier och diskutera varför teamarbete uttrycks som stegvisa utvecklingsmodeller. Speciellt fokus läggs på trestegsmodeller, så kallade triader.

    Vi har identifierat och analyserat fem teoretiska triader som beskriver teamarbete. Forskningsfrågan för denna artikel är: Är teamtypologierna värderande på så sätt att de särskiljer excellenta team från mindre framgångsrika, eller klassificerar de utan att värdera teamens grad av excellens? Är de teoretiska modellerna sorterande eller värderande?

  • 21.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    Sahlgrenska akademin, Göteborgs universitet.
    Sandberg, Håkan
    Akademin för hälsa, vård och välfärd, Mälardalens högskola.
    Models of teamwork: ideal or not?: A critical study of theoretical team models2012In: Team Performance Management, ISSN 1352-7592, Vol. 18, no 5/6, 328-340 p.Article in journal (Refereed)
    Abstract [en]

    Purpose - There is a tendency in team research to employ concepts of stepwise models, reachingfrom the primitive to the excellent, to suggest that a higher level of evolution is better than the basic and simple. This tendency includes typologies of teams. This article aims to question the relevance of this view.

    Design/methodology/approach - Data were collected in three steps. In the first step, articles and books analyzing teams and teamwork from stepwise analytical models were collected. In the second step the collected data were classified into different themes. Each stepwise model was classified into one essential denomination. This classification resulted in eight themes. In the third step each theme was analyzed, which led to the fusion of some of the themes.

    Findings - The conclusion is that a synchronous, complementary or mature team is not necessarily optimal. Contrary to this, a differentiated, sequential or multi team approach can be optimal for some purposes. Team research needs to establish a more open, inductive and critical attitude than at present.

    Originality/value - The paper highlights the need to observe and use team theories in a balanced and critical way.

  • 22.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sandberg, Håkan
    Mälardalens högskola.
    Team i vård, behandling och omsorg: erfarenheter och reflektioner2009In: Team i vård, behandling och omsorg: erfarenheter och reflektioner / [ed] Johan Berlin, Eric Carlström, Håkan Sandberg, Lund: Studentlitteratur , 2009, 15-24 p.Chapter in book (Other academic)
  • 23. Berlin, Johan
    et al.
    Carlström, EricUniversity West, Department of Nursing, Health and Culture, Division of Nursing.Sandberg, Håkan
    Team i vård, behandling och omsorg: erfarenheter och reflektioner2009Collection (editor) (Other academic)
  • 24.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sandberg, Håkan
    Varför team?2009In: Team i vård, behandling och omsorg: erfarenheter och reflektioner / [ed] Johan Berlin, Eric Carlström, Håkan Sandberg, Lund: Studentlitteratur , 2009, 263-276 p.Chapter in book (Other academic)
  • 25.
    Berlin, Johan M
    et al.
    Göteborg University, School of Public Administration,.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    The 20-minute team: a critical case study from the emergency room2008In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, Vol. 14, no 4, 569-576 p.Article in journal (Refereed)
  • 26.
    Berlin, Johan M.
    et al.
    Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    The 90-Second Collaboration: A Critical Study of Collaboration Exercises at Extensive Accident Sites2008In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, Vol. 16, no 4, 177-185 p.Article in journal (Refereed)
  • 27.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Fix och trix i den kommunala ekonomin2010In: Nästan som det brukar vara: kommunal utveckling under ansträngda förhållanden / [ed] Brorström, Björn & Nilsson, Viveca, Göteborg: Kommunforskning i Västsverige (KFi , 2010, 1, 19-25 p.Chapter in book (Other academic)
  • 28.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Knapphetens konsekvens2009In: Krisen som kom av sig?: om att hantera sämre tider / [ed] Nilsson, Viveka, Göteborg: Kommunforskning i Västsverige (KFi) , 2009, 1. uppl., 24-28 p.Chapter in book (Other academic)
  • 29.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Lärande mellan harmoni och konfrontation2010In: Lärande i och för det nya arbetslivet / [ed] Lagrosen, Stefan, Lundh Snis, Ulrika, Nehls, Eddy, Lund: Studentlitteratur , 2010, 1., 47-62 p.Chapter in book (Other academic)
  • 30.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Middle managers on the slide2012In: Leadership in Health Services, ISSN 1751-1879, Vol. 25, no 2, 90-105 p.Article in journal (Refereed)
    Abstract [en]

    Purpose

    – This article aims to examine middle managers in health care and how their role has changed in times of fiscal constraints. It seeks to focus particularly on how cost savings influence the position of middle managers in the organisation between governance and advocacy pressure.

    Design/methodology/approach

    – A total of 25 Swedish middle managers from public health care organisations during fiscal constraints were interviewed about what contributes to their positioning in the organisation.

    Findings

    – The loyalty of middle managers is tested in the "in between" role. Excessive loyalty, in any direction, can distance a middle manager from their expected position. In times of a weakening economy, middle managers are expected to be a tool that is used by the management to communicate savings, personnel reductions, redundancies and closures. This contributes to middle managers sliding out of their role in between.

    Practical implications

    – Middle managers' skills are within care itself. In times of cost savings, demands are placed on their ability to handle advanced management tasks. They need to gain a clearer insight into management control, understanding conflict management and leadership.

    Originality/value

    – The article explains not only why middle managers slide up (take on governance roles) and down (take on advocacy roles) in the organisation, which has been described previously. It also explains why middle managers slide out (abdicate responsibility) of the role between governance and advocacy during times of fiscal limitations.

  • 31.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Neglektiv styrning2007In: Demokratisk och effektiv styrning: en antologi om forskning i offentlig förvaltning, Lund: Studentlitteratur , 2007, 587-606 p.Chapter in book (Other academic)
  • 32.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Team, från vaggan till graven2009In: Team i vård, behandling och omsorg: erfarenheter och reflektioner / [ed] Berlin, Johan, Carlström, Eric, Sandberg, Håkan, Lund: Studentlitteratur , 2009, 1. uppl., 239-262 p.Chapter in book (Other academic)
  • 33.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Vårdchefer: konsten att leda2009 (ed. 1. uppl)Book (Other academic)
  • 34.
    Carlström, Eric
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Boken om team: En kunskapsöversikt om team och teamarbete in hälso- och sjukvården2004Book (Other academic)
  • 35.
    Carlström, Eric
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Berlin, Johan
    Göteborgs universitet / Sahlgrenska akademin.
    Den gula linjen: En kritisk studie av artefakters symbolvärde i hälso-och sjukvårdsteam2009In: Business as usual: The 20th NFF conference, in Turku / Åbo, August 17-21, 2009, 2009, 1-22 p.Conference paper (Refereed)
  • 36.
    Carlström, Eric
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Berlin, Johan
    Göteborgs universitet.
    Var och en på sin kant: om avsaknaden av synkron samverkan på olycksplatsen2009In: Kommunal ekonomi och politik, ISSN 1402-8700, Vol. 13, no 3, 7-22 p.Article in journal (Refereed)
  • 37.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Strategies for change: Adaptation to new accounting conditions2012In: Journal of Accounting and Organizational Change, ISSN 1832-5912, Vol. 8, no 1, 41-61 p.Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to identify middle managers' strategies during changed accounting conditions. Design/methodology/approach - Middle managers from hospitals, primary care and community care were interviewed about their strategies during change processes. Each middle manager selected changes that had played the greatest part in a ten-year period. Findings - Each change was dominated by one strategy that corresponded to the tactics of middle managers during change. They ITquestioned/IT new control models, they ITexperimented/IT with smart budget strategies and they ITimplemented/IT new IT technology. These strategies formed transitions in a continuous circular change model based on Hinings and Malholtra. The study points to two key findings. First, strategies that can be perceived as irrational are organised within a context of plausible explanations; and second, middle managers in public organisations are likely to adopt innovations supported by management policy voluntarily and to question or even reject those prohibited. Research limitations/implications - Criticism may be directed towards the fact that the theoretical model presented in the analysis has an element of determinism. In the model, the managers' control strategies are given limited influence. The theoretical model's strength is that it measures the development in slow-to-change public organisations with long histories and deeply rooted practices. Practical implications - The results can be used to understand the motives of the middle managers' strategies for change. It provides support to management that hesitates between defending a well-established but criticised organisational model, and implementing new and untested approaches. Originality/value - Theoretical change models frequently originate from a management perspective or differentiate between "top-down" and "bottom up" change. In this paper, change is regarded as a generalised process where different phenomena are connected. This forms a circular model that moves between stable phases without change and transformative phases of major change. © 2012 Emerald Group Publishing Limited. All rights reserved.

  • 38.
    Carlström, Eric. D.
    et al.
    University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, PO Box 457, SE-405 30 Gothenburg, Sweden.
    Fredén, Lars
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    The first single responders in Sweden: Evaluation of a pre-hospital single staffed unit2017In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 32, no S1, 15-19 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Single responder (SR) systems have been implemented in several countries. When the very first SR system in Sweden was planned, it was criticised because of concerns about sending single emergency nurses out on alerts. In the present study, the first Swedish SR unit was studied in order to register waiting times and assess the working environment.

    METHOD: Quantitative data were collected from the ambulance dispatch register. Data on the working environment were collected using a questionnaire sent to the SR staff.

    RESULTS: The SR system reduced the average patient waiting time from 26 to 13min. It also reduced the number of ambulance transports by 35% following triage of patient(s) priority determined by the SR. The staff perceived the working environment to be adequate.

    CONCLUSION: The SR unit was successful in that it reduced waiting times to prehospital health care. Contrary to expectations, it proved to be an adequate working environment. There is good reason to believe that SR systems will spread throughout the country. In order to enhance in depth the statistical analysis, additional should be collected over a longer time period and from more than one SR unit.

  • 39.
    Carlström, Eric
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Ullah, Muhammad
    Hur leker olika barn bäst: om sjuksköterskor och biståndsbedömare i kommunal vård och omsorg2002In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 79, no 5, 453-463 p.Article in journal (Refereed)
  • 40.
    Forsgren, Susanne
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Forsman, Berit
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Working with Manchester triage: job satisfaction in nursing2014In: International Emergency Nursing: Oral abstracts – 1st Global Conference on Emergency Nursing & Trauma Care: Dublin, Ireland, 18–21 September 2014, Elsevier, 2014, Vol. 22, no 4, 254-254 p.Conference paper (Refereed)
    Abstract [en]

    Introduction: This study covers nurses' job satisfaction during triage at emergency departments in Western Sweden. Method: Data were collected from 74 triage nurses using a questionnaire containing 37 short form open questions. The answers were analysed descriptively and by measuring the covariance. Two open questions were analysed by content analysis. Results: The results showed a high degree of job satisfaction (88%). Triage as a method, the interesting nature of the work, and a certain freedom in connection with the triage tasks contributed to job satisfaction (R2 = 0.40). The nurses found their work interesting and stimulating, although some reported job dissatisfaction due to a heavy workload and lack of competence. Most of the nurses thought that Manchester Triage System (MTS) was a clear and straightforward method but in need of development. One result from the content analysis was difficulties in decision-making during the assessment of patients with multiple diseases. Since this patient group had increased in number, greater demands were placed on the nurses' competence. Conclusions: The rational modelling structure by which the triage method is constructed is unable to distinguish all the parameters that an experienced nurse takes into account. When the model is allowed to take precedence over experience, it can be of hindrance and contribute to certain estimates not corresponding with the patient's needs. The participants requested regular exercises solving and discussing patient scenarios, which can contribute to develop the instrument.

  • 41.
    Forsgren, Susanne
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Forsman, Berit
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Working with Manchester triage: Job satisfaction in nursing2009In: International Emergency Nursing, ISSN 1755-599X, Vol. 17, no 4, 226-232 p.Article in journal (Refereed)
    Abstract [en]

    This article covers nurses' job satisfaction during triage at emergency departments in Western Sweden. Methods: Data was collected from 74 triage nurses using a questionnaire containing 37 short form open questions. The answers were analyzed descriptively and by measuring the covariance. The open questions were analyzed by content analysis. Results: The results showed a high degree of job satisfaction (88%). Triage as a method, the interesting nature of the work, and a certain freedom in connection with the triage tasks contributed to job satisfaction (R2 = 0.40). The nurses found their work interesting and stimulating, although some reported job dissatisfaction due to a heavy workload and lack of competence. Most of the nurses thought that Manchester triage (MTS) was a clear and straightforward method but in need of development. Conclusions: The rational modelling structure by which the triage method is constructed is unable to distinguish all the parameters that an experienced nurse takes into account. When the model is allowed to take precedence over experience, it can be of hindrance and contribute to certain estimates not corresponding with the patient's needs. The participants requested regular exercises solving and discussing patient scenarios. They also wanted to participate on a regular basis in the development of the instrument.

  • 42.
    Forsman, Berit
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Working with Manchester Triage: Job satisfaction in nursing2011In: EPS Montreal High-Technology Forum 2011: August 15-16, 2011, Montreal, Quebec, Canada : Abstracts, 2011Conference paper (Refereed)
    Abstract [en]

    This study covers nurses' job satisfaction during triage at emergency departments in Western Sweden. Because more and more patients tend to seek care at emergency departments, it is of increasing importance to use methods that secure the patient's medical needs. It is therefore important to treat patients according to need, instead of according to order of arrival.The research question was: What contributes to job satisfaction during triage work? Data was collected from 74 triage nurses using a questionnaire containing 37 short form open questions. The answers were analyzed descriptively and by measuring the covariance. Two open questions prompted the participants to describe two triage scenarios. One of these related to a high level of job satisfaction. The other one was based on an unsatisfactory situation, which meant low or no job satisfaction. From the content analysis, the following core categories were extracted: the MTS method, the work environment at the emergency department, and the individual competence. The results thus consisted of individual and external factors. The open questions revealed that older colleagues at times questioned the triage of the younger ones. Difficulties in decision-making were encountered primarily during the assessment of patients with multiple diseases. Since this patient group had increased in number, greater requirements were placed on the nurses' competence.The results of the survey showed a high degree of job satisfaction (88%). Triage as a method, the interesting nature of the work, and a certain freedom in connection with the triage tasks contributed to job satisfaction (R2=0,40). The nurses found their work stimulating and interesting, although some reported job dissatisfaction due to a heavy work load and lack of competence. Most of the nurses (63%) thought that MTS was a difficult method with some disadvantages. MTS could not always distinguish all the parameters that an experienced nurse took into account during triage estimates. This could imply that the rational modeling structure by which the triage method is constructed is unable to distinguish all the parameters that an experienced nurse takes into account. When the model is allowed to take precedence over experience, it can be of hindrance and contribute to certain estimates not corresponding with the patient's needs. This was reflected in that as many as a third of the participants did not feel that MTS was safe for patients. Such factors reduced job satisfaction.The participants requested regular exercises solving and discussing patient scenarios. They also wanted to participate on a regular basis in the development of MTS. The method can thus contribute to a smooth work environment with high precision for certain groups of nurses. There are therefore good reasons to further research the influence of MTS in triage work. 

  • 43.
    Forsman, Berit
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Forsgren, Susanne
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Nurses working with Manchester triage: The impact of nursing experience on patient safety2012In: Australasian Emergency Nursing Journal, Vol. 15, no 2, 100-107 p.Article in journal (Refereed)
    Abstract [en]

    Background

    There is in Sweden an ongoing debate about the extent to which the practice of triage contributes to patient safety. This paper reports the findings of a study of nurses’ perceptions of the impact of experience and safety of the Manchester Triage System (MTS) within emergency departments in Western Sweden.

    Methods

    Data was collected from 74 triage nurses using a questionnaire containing 37 short form questions of Likert-type, analyzed descriptively and measured the covariance. Data was also collected with two open questions by using the critical incident technique and content analysis.

    Results

    The results described that the combination of the MTS method, the nurses’ experience and organizational factors accounted for 65% of patient safety. The study indicated that nurses’ experience contributed to higher patient safety than the model itself. A standardized assessment model, like MTS, can rarely capture all possible symptoms, as it will always be constrained by a limited number of keywords and taxonomies. It cannot completely replace the skills an experienced nurse develops over many years in the profession.

    Conclusions

    The present study highlights the value of triage nurse's experience. The participants considered experience to contribute to patient safety in emergency departments. A standardized triage model should be considered as additional support to the skills an experienced nurse develops.

  • 44.
    Johansson, Catrin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Daily Life Dialogue Assessment in Psychiatric Care—Face Validity and Inter-Rater Reliability of a Tool Based on the International Classification of Functioning, Disability and Health2013In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, no 6, 306-311 p.Article in journal (Refereed)
    Abstract [en]

    This article describes the development of an assessment tool based on the International Classification of Functioning Disability and Health (ICF) adapted to a psychiatric nursing context where both the patient and the nurse assess the patient's ability to participate in various spheres of life. The aim was to test psychometric properties, focusing on face validity and inter-rater reliability. Three Swedish expert groups participated. Analysis of inter-rater reliability was conducted through simulated patient cases. The results of an unweighted kappa value of 0.38, a linear weighted kappa value of 0.65 and a quadratic weighted kappa value of 0.73 were considered as acceptable when using simulated patient cases.

  • 45.
    Johansson, Catrin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Helldin, Lars
    The NU Health Care, Department of Psychiatry, SE-461 85 Trollhättan.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Culture as a predictor of resistance to change: A study of competing values in a psychiatric nursing context.2014In: Health Policy, ISSN 0168-8510, ISSN 1872-6054 (Online), Vol. 114, no 2-3, 156-162 p.Article in journal (Refereed)
    Abstract [en]

    It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions.

  • 46.
    Khorram-Manesh, Amir
    et al.
    Göteborgs universitet .
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    Göteborgs universitet .
    Two Validated Ways of Improving the Ability of Decision-Making in Emergencies: Results from a Literature Review2016In: Bulletin of Emergency Trauma, ISSN 2322-2522, Vol. 4, no 4, 186-196 p.Article in journal (Refereed)
    Abstract [en]

    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.

  • 47.
    Olofsson, Pia
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Bäck-Pettersson, Siv
    NU-Hospital Organisation, Trollhättan,Department of Research and Development.
    During and beyond the triage encounter: Chronically ill elderly patients' experiences throughout their emergency department attendances.2012In: International emergency nursing, ISSN 1878-013X, Vol. 20, no 4, 207-13 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chronically ill elderly patients are frequent users of care in emergency departments (EDs). Due to their presenting symptoms, these patients are often assessed on a low urgency level of priority by the triage nurse.

    AIM: The aim of the study was to explore and describe the experiences of a group of chronically ill elderly patients' during their triage encounter and subsequent ED stay.

    METHOD: The data consisted of 14 open-ended interviews with chronically ill patients aged between 71 and 90years. A lifeworld approach was used in order to describe the essence of patient experiences. The study was carried out with a descriptive phenomenological research perspective.

    CONCLUSION: The visit to the ED was experienced as contradictory. The triage encounter fostered confidence and set promising expectations, but during the rest of the visit, the patient felt abandoned and considered the staff to be uncommitted and reluctant. These ambiguous experiences of their ED visits indicate a need for exploring possible ways of improving the situation for the chronically ill older person in ED.

  • 48.
    Olofsson, Pia
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Triage på akutmottagning: en utvärdering av triage i Västra Götalandsregionen2008Report (Other academic)
    Abstract [sv]

    Triage är en systematiserad form av prioritering som utförs på de flesta akutmottagningar i Sverige och internationellt. Syftet med triage är att uppnå en medicinskt säkerställd turordning för patienter som söker vård. I Västra Götalandsregionen har akutmottagningarna de senaste två åren implementerat Manchester Triage (MTS). Modellen består av ett medicinskt beslutsstöd i form av ett flödesschema, samt fem triagekategorier, som var och en anger maximal väntetid. Patienterna som bedöms tillhöra kategori 1 behöver omedelbar läkarkontakt. De övriga fyra kategorierna bedöms kunna vänta mellan 10 minuter och upptill 240 minuter. Den här studien utvärderar överensstämmelsen i form av mellanbedömarreliabilitet, samt träffsäkerhet i triagebedömningar hos sjuksköterskor som arbetar med MTS. De 79 sjuksköterskor som deltog i studien var verksamma på sju olika akutmottagningar i Västra Götalandsregionen. Sjuksköterskorna bedömde 13 fiktiva patientfall vardera. Dessa patientfall hade tilldelats en förväntad triagekategori utifrån en expertgrupps samlade bedömning. Mellanbedömar-reliabiliteten för akutmottagningarna totalt var 0,61 i oviktat k-värde vilket innebär god överensstämmelse. Mellan akutmottagningarna varierade k-värdet från 0,56-0,65. Träffsäkerheten gentemot expertgruppens förväntade triagekategori var 73 % totalt. 14 % av patienterna tilldelades en högre triagekategori än den förväntade (övertriage) och 13 % en lägre (undertriage). Träffsäkerheten för MTS var hög i kategori 1 (92 %) och kategori 2 (91 %), men lägre i kategori 3 (66 %) och 4 (63 %). Slutsatsen är att mellanbedömar-reliabiliteten var god och träffsäkerheten hög. Triagekategori 1 och 2 redovisade högst värden, vilket tyder på att denna grupp av patienter bereds vård utan riskfyllda väntetider. De patienter som ges en lägre prioritet visar sig emellertid vara svåra att bedöma. Trots att dessa patienter är mest frekventa på akutmottagningarna var de svåra att särskilja. Detta pekar på ett behov av att ytterligare utveckla bedömningar av kategori 3 och 4 i triagemodellen MTS.

  • 49.
    Olofsson, Pia
    et al.
    Nu-sjukvården, Trollhättan, Department of Emergency Medicin.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Carlström, Eric. D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Manchester Triage in Sweden: Interrater reliability and accuracy2009In: International Emergency Nursing, Vol. 17, no 3, 143-148 p.Article in journal (Refereed)
    Abstract [en]

    This study investigates the interrater reliability and the accuracy of Manchester Triage (MTS) at emergency departments in Western Sweden. Methods: A group of 79 nurses from seven emergency departments assessed simulated patient cases and assigned triage categories using the same principles as in their daily work. K statistics, accuracy, over-triage and under-triage were then analyzed. The nurses performed 1027 triage assessments. Results: The result showed an unweighted κ value of 0.61, a linear weighted κ value of 0.71, and a quadratic weighted κ value of 0.81. The determined accuracy was 92% and 91% for the two most urgent categories, but significantly lower for the less urgent categories. Conclusions: Patients in need of urgent care were identified in more than nine out of 10 cases. The high level of over-triage and under-triage in the less urgent categories resulted in low agreement and accuracy. This may suggest that the resources of emergency departments can be overused for non-urgent patients.

  • 50.
    Olsson, Maivor
    et al.
    NU-Hospital Organisation, Department of Psychiatry, Trollhättan.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing. University of Gothenburg, Academy of Sahlgrenska, Institute of Health and Care Sciences, Gothenburg.
    Marklund, Bertil
    University of Gothenburg, Academy of Sahlgrenska, Institute of Medicine,.
    Helldin, Lars
    NU-Hospital Organisation, Department of Psychiatry, Trollhättan.
    Hjärthag, Fredrik
    University of Karlstad, Karlstad, Department of Psychology, Sweden.
    Assessment of Distress and Quality of Life: A Comparison of Self-Assessments by Outpatients with a Schizopsychotic Illness and the Clinical Judgment of Nurses2015In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 29, no 5, 284-289 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate how self-assessments of perceived distress and quality of life in patients with schizopsychotic illness are associated with nurse assessments of symptoms, function and life situation. Data were obtained through interviews that used evidence-based rating and visual analogue self-rating scales. Descriptive statistics, correlation and regression analyses were used to process the data. The results demonstrated that the patient self-ratings did not correlate with the nurse assessments, and the perceived distress was not affected by remission status. The findings indicate that patient self-assessments are not a sufficient basis for decisions regarding appropriate treatment interventions.

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