<p><strong> </strong></p><p>There is a lack of research in the field of quality improvement efforts based on profound knowledge in social services. The current situation is therefore a significant knowledge gap in terms of studies of this type of systematic quality work and how it is applied in practice. This study therefore intends to describe Pilbackens quality work and further examine if the profound knowledge is consistent with quality work in microsystems by an analysis of Pilbackens work. The present study has been performed by a qualitative method and the material is collected through semi-structured interviews. In order to analyze the study’s result have profound knowledge and the model microsystems been used. The results show that Pilbackens in quality improvement efforts have made numerous changes in its organization. They have via a clear purpose and objective of working with quality in microsystems achieved a number of perceived and documented results. The analysis of Pilbackens quality work shows a compliance with profound knowledge and the ability incorporate microsystems in practice.</p>

There is a lack of research in the field of quality improvement efforts based on profound knowledge in social services. The current situation is therefore a significant knowledge gap in terms of studies of this type of systematic quality work and how it is applied in practice. This study therefore intends to describe Pilbackens quality work and further examine if the profound knowledge is consistent with quality work in microsystems by an analysis of Pilbackens work. The present study has been performed by a qualitative method and the material is collected through semi-structured interviews. In order to analyze the study’s result have profound knowledge and the model microsystems been used. The results show that Pilbackens in quality improvement efforts have made numerous changes in its organization. They have via a clear purpose and objective of working with quality in microsystems achieved a number of perceived and documented results. The analysis of Pilbackens quality work shows a compliance with profound knowledge and the ability incorporate microsystems in practice.

Syfte: Att skapa förutsättningar för en förbättrad cancervård, genom att fördjupa kunskapen och förståelsen om behov hos huvud- och halscancerpatienter under cancerprocessen. Därutö- ver önskas ett förbättrat omhändertagande genom att implementera och utvärdera kvalitetshö- jande förbättringsinsatser. Satsningen ska resultera i en trygg och smidig resa genom vården med ett minimum av avbrott mellan olika vårdhändelser. Metod: Patientens vårdkedja studerades med en fallstudie, utifrån en aktionsforskningsansats. Behoven identifierades med patientskuggning, reflektion från observationer och semistruktu- rerade fokusgruppsintervjuer med mikrosystemet, före (referensgrupp) och efter intervention (jämförelsegrupp). Analys genomfördes med kvalitativ innehållsanalys och Kano-modell. Resultat: En fast vårdkontakt var en viktig faktor i vårdkedjan. Den fasta vårdkontakten till- mötesgick behov såsom trygghet och tillgänglighet, vilket medförde en smidigare vårdkedja. Under hela vårdförloppet fanns ett stort behov av stöd, praktiskt liksom psykosocialt, från både profession och närstående. Oberoende av position i vårdkedjan önskades individanpas- sad information och ett gott bemötande. Interventionsgruppen rapporterade bättre tillgänglig- het och stöd i förhållande till jämförelsegruppen, som inte hade tillgång till kontaktsjukskö- terska. Involvering av hela mikrosystemet vid analys med Kano-modell medför att behov och förbättringsmöjligheter identifieras och valideras. Slutsatser: En kontaktsjuksköterska kan utgöra en fast vårdkontakt som tillmötesgår och sä- kerställer cancerpatienters behov. Närstående är en viktig del av mikrosystemet och måste beredas utrymme och resurser. En förbättringsinsats genom implementering av kontaktsjuk- sköterska, utformning av nutritions- och kvalitetsregisterrutiner baserat på patientens behov bidrar till god vård och minskar risken för resursslöseri. Studien har även bidragit med fördju- pad kunskap gällande applicering av Kano-modellen i Hälso- och sjukvårdsmiljö. / Purpose: To create opportunities for an improved cancer care, by providing deeper knowledge and understanding of the needs of head and neck cancer patients during the cancer treatment process. Furthermore, to improve care for these patients by implementing and eval- uating QI efforts. This will result in a safe and smooth journey through the care with a mini- mum of disruption. Method: The cancer treatment process was examined in a case study with an action research approach. Patient needs were identified by patient-shadowing, observational reflections and focus groups-interviews with the microsystem, before (non-intervention group) and after in- tervention (intervention group). The data analysis involved qualitative content analysis in- formed by Kano’s quality model. Results: A contact nurse (CN) was an important factor. The CN provided a sense of security and accessibility, giving patients a smoother trajectory of care. Continual support was needed, regarding both, practical and psychosocial matters, from both professionals and relatives. Re- gardless of position in the continuum of care, individual information and good reception was required. Members of the intervention group reported better accessibility and support com- pared to the non-intervention group members, who were not offered a CN. Conclusion: A CN can provide a continual health care contact; meeting and ensuring that the needs of cancer patients are met. Relatives are an important part of the microsystem and should be given space and resources. An improvement effort by implementing routines for a CN, quality registry and nutrition, based on patient needs will facilitate good care and opti- mise resources. The study has also contributed to deeper knowledge of how to use the Kano model in health care.

PureFize Technologies AB develops and manufactures a broadband ultraviolet (UVC) light technology device that is mercury-free and based on nanotechnology, using the principle of field emission. The light source is made of Ti and glass, which are hermetically bonded, using a low-temperature glass frit, at elevated temperatures. The bonding procedure will induce stresses in the device originating from the mismatch of the coefficient of thermal expansion (CTE) between the materials. Brittle materials, as glass, withstands tensile stresses poorly. Therefore, the stress magnitude and distribution needs to be understood.  This work develops a quality inspection method for the glass bond and internal stresses, as well as stress simulations of the device, to be used in production at the company. The glass bond width and the internal stresses in the device were classified and analyzed by light optical microscopy and by polarised light optical microscopy. The optical analysis was followed by pressure tests of the devices using a chamber that allowed for pressurized air up to 7 bar. In parallell with the experimental work, stress and deformation simulations of the device using the finite element method (FEM) was made. Data collected from the inspections and pressure tests were compiled and analyzed, showing clear connections between the glass bond quality and the device's ability to withstand external pressure. A narrow glass bond could withstand external pressure poorly, whereas a wide glass bond could withstand external pressure well. Correlations could be made both between the glass bond appearance and the stress patterns, as well as between the FEM simulations and the stress patterns in the device. It is clear that the stresses induced in the device after bonding originates from the CTE mismatch of the bonded components when cooling it from the bonding temperature to room temperature. The pressure testing method proved to be an efficient way of verifying the maximum pressure capacity of the devices.  The knowledge from this thesis can be used when further investigating induced stresses from glas frit bonding.