Themes | Contextual factors |
---|---|
Geographical location, municipality size | Size of municipality Geographical distance to hospital/within the municipality Access to proper competence and networks in the municipality Number of departments/organizational size/employees |
Access to resources and proper competence | Financial situation/time pressure Access to doctors and nurses (recruitment) Existing resource groups/persons/professional development positions Competence in the organization |
Organizing of services, distribution of responsibility | Organizing of quality and safety Managerial levels Type of services and user/patient groups Treatment level Team organizing Communication with decision makers in the municipality |
Systems and tools for QI | Type of incident reporting system (paper-based/digital) Use of checklists Use of register or monitoring system for patient indicators |
Network within and outside the municipality to support managers | Committees (quality, patient safety, user) Research and development unit Contact with development centers in the region Employed doctor at the nursing home Resource groups at the municipal/regional/national level |
External demands and guidelines | Key national policy documents and regulation Demands for documentation Participation in national programmes Care coordination demands and safety in transitional care |
Communication, culture, and meeting points as part of the managerial work | Meeting arenas between managers and healthcare professionals Meeting arenas for managers Functionality of IT-systems as communication tool |
User involvement in user-panels, user surveys | User panel Elderly user panel/next-of-kin panel/next-of-kin representation in user panel Use of user surveys |
Current change processes within the municipality | Ongoing/recent organizational change processes Resistance to change Current implementation of improvement measures |