Relationskontinuitet i hälso- och sjukvårdens patientflöden : En fallstudie i svensk primärvård ur ett flödesperspektiv

Sammanfattning: ABSTRACT Purpose - The quality of health care is lacking, and increased continuity of care can contribute to and be a prerequisite for increasing quality. Despite the knowledge of the good effects of continuity of care, there is a knowledge gap in what it takes to achieve it. Thus, the purpose of the study is: To investigate barriers and opportunities for continuity of care in healthcare patient flows. Method - The study is a case study that combines both qualitative and quantitative data. The study began with a pilot study that included literature studies and dialogues with the organization. To collect data, the data collection techniques used were document study, observation and interview. The collected data were analyzed continuously and was compared and strengthened by theory to confirm the validity of the study. To further increase validity, triangulation was considered as an essential part of the study. Results - The study's results show that the extent of continuity of care is seen to differ between ambition and ability, the ambition is high, but the ability is low. Furthermore, the barriers to continuity of care were identified as a lack of availability in terms of staff, the healthcare IT system and the idea of the current way of working as a single solution to maintain continuity of care. Additional barriers identified were emergency cases and the time aspect. Based on the barriers, improvement proposals have been developed, through changes that should take place in the long term, but also how the work for continuity of care can be improved through the existing conditions. Implications - Based on the results of the study, theoretical and practical implications have been developed. A new dimension of existing theory has been discovered, which suggests that flow efficiency can lead to continuity of care. Through this, it has also been established that the flow perspective can have good effects in health care. It has been confirmed that there is a lack of continuity of care, and a deeper understanding of the reasons for this has been obtained. Practical implications have been obtained in the form of the improvement proposals produced in the results. Limitations - The case study is designed as a single case design, which limits the generalizability of the study as only one unit of analysis has been studied. It has been observed during the study that there are misregistration’s in the healthcare IT system. Document study data have been drawn from this system, resulting in a limitation of the reliability of that data.