Ökad tillgänglighet med multipla interventioner : Identifiering av motivationsfaktorer i ett förbättringsarbete utifrån self-determination theory

Sammanfattning:

Background

The population of Sweden and most of the world are becoming larger and older. This will mean more people seeking care. Health care today is already strained by waiting lists for outpatient care and operation. Public healthcare purchasing private healthcare or expands with additional clinics has not proven to be successful alternatives. Motivation based on self-determination theory (SDT) has been studied during the project. An important part of SDT is that external motivation is divided into four different degrees; external regulation, introjected regulation, identified regulation and integrated regulation. SDT also argues that the required nutrition to motivation is  autonomy, competence and relatedness.

Purpose

The improvement work aims to increase access to healthcare in an orthopedic clinic without extra appointments or buying private care. The study highlights the factors that feed motivation based on SDT.

Method

A pilot study identified that balance, registration of patients and controls were keys for availability. These three elements were processed through PDSA in a project. The study is based on a mixed approach with survey and focus interviews.

Results

The result shows that the queues at the outpatient unit can be reduced with the initiatives implemented (control, balance and right registration). The difficulty, however, is to find balance between the various capacities and balance seasonal variation. The study shows clearly the importance of autonomy for motivating employees. Having the power or being powerless affect the autonomy greatly.