A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study

Background Consensus on priorities to optimize the sick leave and rehabilitation process (SRP) is lacking.Objective To explore perspectives of stakeholders in the SRP on bridging the gap between desired process scope, and actual practice, from a multi-professional, multi-organizational, and interdis...

Full description

Saved in:
Bibliographic Details
Main Authors: Märit Löfgren, Karin Törnbom, Daniel Gyllenhammar, Lena Nordeman, Gun Rembeck, Cecilia Björkelund, Irene Svenningsson, Dominique Hange
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Scandinavian Journal of Primary Health Care
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/02813432.2024.2434123
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846142694908231680
author Märit Löfgren
Karin Törnbom
Daniel Gyllenhammar
Lena Nordeman
Gun Rembeck
Cecilia Björkelund
Irene Svenningsson
Dominique Hange
author_facet Märit Löfgren
Karin Törnbom
Daniel Gyllenhammar
Lena Nordeman
Gun Rembeck
Cecilia Björkelund
Irene Svenningsson
Dominique Hange
author_sort Märit Löfgren
collection DOAJ
description Background Consensus on priorities to optimize the sick leave and rehabilitation process (SRP) is lacking.Objective To explore perspectives of stakeholders in the SRP on bridging the gap between desired process scope, and actual practice, from a multi-professional, multi-organizational, and interdisciplinary approach.Design and setting Focus group interviews were conducted with various SRP frontline professionals in Region Västra Götaland, Sweden, using purposive sampling to capture a range of experiences. Participants discussed their perceptions of critical changes and priorities needed to meet patients’ SRP needs in a primary care context. All interviews were analyzed using systematic text condensation, as described by Malterud.Subjects General practitioners (n = 6), rehabilitation coordinators and licensed healthcare professionals from primary healthcare (n = 13), administrators from the Social Insurance Agency, the Employment Agency and Social Services (n = 12).Results Through data analysis, the following themes emerged: 1) The need for rules and regulations to enable coherent process governance 2) Challenges and opportunities in person-centered SRP: Professional collaboration, organizational priorities, and the need for enhanced leadership, and 3) Balancing resources and patient needs in the SRP: How to improve care quality and accessibility. In summary, participants mainly discussed how to improve process efficiency and quality of care while balancing available resources and a heavy workload. A main goal was to prevent negative spirals of suboptimal decision-making in individual cases, which could lead to increased work, unfortunate outcomes, and patient suffering.Conclusions This qualitative study indicated that gaps between a desired process scope and actual practice might be bridged by enabling coherent cross-organizational process governance, prioritizing person-centered ways of working, and balancing available resources and workload. The above changes were believed to improve process quality and overall efficiency.Trial registration The study project plan was pre-registered on September 21st, 2020, in the database FOU i VGR (researchweb.org), project number 274941.
format Article
id doaj-art-5b9d0a4aa50144eb8de4ae576909dfc2
institution Kabale University
issn 0281-3432
1502-7724
language English
publishDate 2024-12-01
publisher Taylor & Francis Group
record_format Article
series Scandinavian Journal of Primary Health Care
spelling doaj-art-5b9d0a4aa50144eb8de4ae576909dfc22024-12-03T06:10:40ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242024-12-0111410.1080/02813432.2024.2434123A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview studyMärit Löfgren0Karin Törnbom1Daniel Gyllenhammar2Lena Nordeman3Gun Rembeck4Cecilia Björkelund5Irene Svenningsson6Dominique Hange7General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenGeneral Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Technology Management and Economics, Centre of Healthcare Improvements, Chalmers University of Technology, Gothenburg, SwedenRegion Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Södra Älvsborg, SwedenGeneral Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenGeneral Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenGeneral Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenGeneral Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenBackground Consensus on priorities to optimize the sick leave and rehabilitation process (SRP) is lacking.Objective To explore perspectives of stakeholders in the SRP on bridging the gap between desired process scope, and actual practice, from a multi-professional, multi-organizational, and interdisciplinary approach.Design and setting Focus group interviews were conducted with various SRP frontline professionals in Region Västra Götaland, Sweden, using purposive sampling to capture a range of experiences. Participants discussed their perceptions of critical changes and priorities needed to meet patients’ SRP needs in a primary care context. All interviews were analyzed using systematic text condensation, as described by Malterud.Subjects General practitioners (n = 6), rehabilitation coordinators and licensed healthcare professionals from primary healthcare (n = 13), administrators from the Social Insurance Agency, the Employment Agency and Social Services (n = 12).Results Through data analysis, the following themes emerged: 1) The need for rules and regulations to enable coherent process governance 2) Challenges and opportunities in person-centered SRP: Professional collaboration, organizational priorities, and the need for enhanced leadership, and 3) Balancing resources and patient needs in the SRP: How to improve care quality and accessibility. In summary, participants mainly discussed how to improve process efficiency and quality of care while balancing available resources and a heavy workload. A main goal was to prevent negative spirals of suboptimal decision-making in individual cases, which could lead to increased work, unfortunate outcomes, and patient suffering.Conclusions This qualitative study indicated that gaps between a desired process scope and actual practice might be bridged by enabling coherent cross-organizational process governance, prioritizing person-centered ways of working, and balancing available resources and workload. The above changes were believed to improve process quality and overall efficiency.Trial registration The study project plan was pre-registered on September 21st, 2020, in the database FOU i VGR (researchweb.org), project number 274941.https://www.tandfonline.com/doi/10.1080/02813432.2024.2434123Primary health caresick leavepatient care managementpatient-centered careSweden
spellingShingle Märit Löfgren
Karin Törnbom
Daniel Gyllenhammar
Lena Nordeman
Gun Rembeck
Cecilia Björkelund
Irene Svenningsson
Dominique Hange
A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
Scandinavian Journal of Primary Health Care
Primary health care
sick leave
patient care management
patient-centered care
Sweden
title A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
title_full A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
title_fullStr A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
title_full_unstemmed A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
title_short A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
title_sort systems perspective on gaps in the person centered sick leave and rehabilitation process a swedish interview study
topic Primary health care
sick leave
patient care management
patient-centered care
Sweden
url https://www.tandfonline.com/doi/10.1080/02813432.2024.2434123
work_keys_str_mv AT maritlofgren asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT karintornbom asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT danielgyllenhammar asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT lenanordeman asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT gunrembeck asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT ceciliabjorkelund asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT irenesvenningsson asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT dominiquehange asystemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT maritlofgren systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT karintornbom systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT danielgyllenhammar systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT lenanordeman systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT gunrembeck systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT ceciliabjorkelund systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT irenesvenningsson systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy
AT dominiquehange systemsperspectiveongapsinthepersoncenteredsickleaveandrehabilitationprocessaswedishinterviewstudy