Studies show that older is an increased proportion patients in hospital and that it is a patient group that can be difficult to communicate with because of older patients' often multiple disease picture. Relatives to the patient can be help for caregivers in the communication and the care of the patient. The aim with the study was to examine relative's experience of participation, meeting/support, accessibility and information on a geriatrics rehabilitation care unit. The study had a descriptive design and was designed as a questionnaire study. It was implemented on one geriatrics rehabilitation care unit on the countryside in central Sweden, belong to Uppsala University hospital. The number questionnaires that were distributed out were 49 and the reply frequency was 82 %. The result showed that most relatives in the study were satisfied with participation, meeting/ support, accessibility and information. The result showed also on a significance correlation between participation and meeting/ support, accessibility and information. The study did not reveal any difference between men and women concerning the experience of participation. Likewise, no correlation was revealed on between how long time the patient where in hospital and the experience of participation. Relatives experienced to have a relative good contact with the doctor, but a part stated however that they did not have any opinion about it. Our conclusion is that the concept to participation is meeting/ support, accessibility and information. / Studier visar att äldre är en ökande andel patienter i vården och att det är en patientgrupp somkan vara svår att kommunicera med på grund av äldre patienters ofta multipla sjukdomsbild. Närstående till patienten kan vara till hjälp för vårdgivaren i kommunikationen och vården av patienten. Syftet med studien var att undersöka närståendes självskattade upplevelse av delaktighet,bemötande, tillgänglighet och information på en geriatrisk rehabiliteringsavdelning. Studien hade en deskriptiv design och var utformad som en enkätstudie. Den genomfördes på en geriatrisk rehabiliteringsavdelning på landsbygden i centrala Sverige tillhörande Akademiska sjukhuset. Antalet enkäter som delades ut var 49 stycken och svarsfrekvensen var 82 %. Resultatet visade att de flesta närstående i studien var nöjda med delaktighet, bemötande, tillgänglighet och information. Resultatet visade även på en signifikans gällande samvariation mellan delaktighet och bemötande, tillgänglighet och information. Studien visade inte på någon signifikans gällande skillnaden mellan män och kvinnor avseende upplevelsen av delaktighet. Likaså påträffades ingen signifikans mellan hur lång tid patienten var inneliggande och den närståendes upplevelse av delaktighet. Närstående upplevde sig ha en relativt bra kontakt med ansvarig läkare men en stor del uppgav dock att de inte hade någon uppfattning. Vår slutsats är att nyckeln till delaktighet är bemötande, tillgänglighet och information.

Patientsäkerhet och arbetet för att hindra uppkomsten av vårdskador är ett högaktuellt område. Problemet med undvikbara vårdskador är omfattande och i Sverige uppges vårdskador orsaka 630 000 extra vårddygn på ett år, vilket medför både ett mänskligt lidande men också ekonomiska konsekvenser för samhället. Antalet patienter som skadas av vården är ett direkt mått på patientsäkerheten. Brister i kommunikation och teamarbete är en betydande orsak till att vårdskador uppstår. Syftet med studien, som utfördes som en litteraturöversikt, var att belysa faktorer som kunde påverka kommunikationen och teamarbetet i hälso- och sjukvården samt vilken betydelse dessa hade för patientsäkerheten. Femton vetenskapliga artiklar analyserades och resultatet visar att kommunikation och teamarbete påverkas av faktorer såsom tillåtande klimat, arbetsmiljö, organisation och ledarskap samt utbildning i kommunikation och teamarbete. Kunskap och färdigheter inom kommunikation och teamarbete ansågs vara lika viktigt som den kliniska kompetensen men har hittills inte prioriterats i tillräcklig utsträckning. Detta visar på ett ökat behov av utbildning för att på så vis kunna förbättra förutsättningarna för att utöva en patientsäker vård. / Patient safety and the task of preventing the occurrence of adverse events is a highly current issue. The problem with adverse events is extensive and in Sweden, adverse events are causing 630 000 additional days of health care each year resulting in human suffering as well as financial consequences for the society. The number of patients harmed due to hospital-acquired conditions is a direct measurement of patient safety.  Inadequate communication and teamwork is a significant reason for the occurrence of adverse events. The purpose of this study, performed as a literary survey, was to illustrate factors that could influence the communication and teamwork in the health care setting and the significance this had for patient safety. Fifteen scientific articles were analyzed and the results showed that communication and teamwork were influenced by a number of factors such as permitting climate, work environment, organization and leadership, and education in communication and teamwork. Knowledge and skills in communication and teamwork is just as important as the clinical skills but has, as of yet, not been prioritized enough which indicates that there is an increased need for education and training in order to improve the conditions for a safe practice in patient care.

Vi har kommit fram till att kontorets framgångsfaktorer ligger bl.a. i på vilket sätt personalen rekryteras, teamarbetet, företagskulturen samt att personalen delar med sina kompetenser och erfarenheter och bollar idéer med varandra. Att personalen rekryterar lämpliga konsulter på rätt arbetsplats är andra framgångsfaktorer enligt oss. Vi har utformat ett koncept i form av en stjärna till kontoret som ett bidrag till fortsatt utveckling.      Vi har kommit fram till att kontorets framgångsfaktorer ligger bl.a. i på vilket sätt personalen rekryteras, teamarbetet, företagskulturen samt att personalen delar med sina kompetenser och erfarenheter och bollar idéer med varandra. Att personalen rekryterar lämpliga konsulter på rätt arbetsplats är andra framgångsfaktorer enligt oss. Vi har utformat ett koncept i form av en stjärna till kontoret som ett bidrag till fortsatt utveckling. / We came to the conclusion that the success factors are, the ways in which the staff got recruited, team work, the corporate culture and that staff share their skills and experiences and develop ideas with each other. According to us the main success factor rests on the fact that manpower is able to recruits suitable staff consultants to the right company. We have designed a concept in the form of a star to the office as a contribution for further development.

The purpose of this study has been to explore students’ subjective experience of learning and development in Experts in Teamwork (EiT), with a focus on personal competence. The basis for the study has been the question of research; How do students experience Experts in Teamwork facilitating the development of personal competence? This research is a Q-methodological study, where 36 participants have conducted a Q-sort. This means that they did a sort of 36 statements on an array from most agree (+5) to most disagree (-5), in a qu asi-normal distribution form. The statements were obtained from a research design based on Fisher ’s balanced block design. The participants Q-sorts were the basis for the factor analysis. The factor analysis of the data set, conducted by PQ-method-2.11, gave a four-factor solution founded on statistical and theoretical criteria. The different factors represent the most prominent point of views that were present amongst the participants. The different factors were; Factor 1: Personal development, feedback and group experiences are valuable to me. Factor 2: I trust the system to facilitate my learning trough theory-based learning. Factor 3: I want feedback and group work, but I don’t trust the system . Factor 4: Theory-based learning is what I prefer. Group work is scary . In the thesis these findings are discussed in relation to the theoretical frames; personal competence, experiential learning, mindset and selfunderstanding.The aspects that are highlighted are what I have found to be most prominent and that could contribute to give a holistic picture of the data set.

Comparisons of raw span (i.e., number of staff who report directly to a manager) within and across organizations can misrepresent managerial capacity to support staff because managers may not allocate the same amount of time to staff contact. The purpose was to examine the influence of alternative measures of managerial span on nurse satisfaction with manager’s supervision and on multidisciplinary teamwork. The alternative measures were (a) raw span as a measure of reporting structure and (b) time in staff contact as a measure of closeness of contact by the manager. The main effects of the alternative measures, leadership, hours of operation, and other covariates on outcomes were examined. The interaction effects of the alternative measures with leadership and hours of operation were investigated. The study framework was based on Open System Theory and the boundary spanning functions of managers. A descriptive, correlational design was used to collect survey and administrative data from employees, managers, and organizations. Managerial time allocation data were collected through self-logging and validated through observation. Acute care hospitals were selected through purposive sampling. For supervision satisfaction, the final sample size was 31 first-line managers and 558 nurses. For teamwork, the final sample size was 30 first-line managers and 754 staff. The Leadership Practices Inventory, the Satisfaction with my Supervisor Scale, and the Relational Coordination Scale were used. Hierarchical linear modeling was the main type of analysis conducted. Raw span interacted with leadership and hours of operation to explain supervision satisfaction. Teamwork was explained by leadership, clinical support roles, hours of operation, total areas, and non-direct reports, but not by raw span or time in staff contact. Large acute care hospitals can improve satisfaction with supervision and teamwork by modifying first-line management positions.

Cognitive Work analysis (CWA) as an analytical approach for examining complex socio-technical systems has shown success in modeling the work of single operators. The CWA approach allows room for social and team interactions, but a more explicit analysis of team aspects can reveal more information for systems design. CWA techniques and models do not yet provide sufficient guidance on identifying shared constraints, team strategies, or social competencies of team players. In this thesis, I explore whether a team approach to CWA can yield more information than a typical CWA. Team CWA techniques and models emerge and extend from theories and models of teamwork, past attempts to model teams with CWA, and the results of two sets of observational studies. The potential benefits of using Team CWA models in domains with strong team collaboration are demonstrated through the results of a two-week observation at the Labour and Delivery Department of The Ottawa Hospital and a fifteen-week observation at the IBM Ottawa Software Group.

Comparisons of raw span (i.e., number of staff who report directly to a manager) within and across organizations can misrepresent managerial capacity to support staff because managers may not allocate the same amount of time to staff contact. The purpose was to examine the influence of alternative measures of managerial span on nurse satisfaction with manager’s supervision and on multidisciplinary teamwork. The alternative measures were (a) raw span as a measure of reporting structure and (b) time in staff contact as a measure of closeness of contact by the manager. The main effects of the alternative measures, leadership, hours of operation, and other covariates on outcomes were examined. The interaction effects of the alternative measures with leadership and hours of operation were investigated. The study framework was based on Open System Theory and the boundary spanning functions of managers. A descriptive, correlational design was used to collect survey and administrative data from employees, managers, and organizations. Managerial time allocation data were collected through self-logging and validated through observation. Acute care hospitals were selected through purposive sampling. For supervision satisfaction, the final sample size was 31 first-line managers and 558 nurses. For teamwork, the final sample size was 30 first-line managers and 754 staff. The Leadership Practices Inventory, the Satisfaction with my Supervisor Scale, and the Relational Coordination Scale were used. Hierarchical linear modeling was the main type of analysis conducted. Raw span interacted with leadership and hours of operation to explain supervision satisfaction. Teamwork was explained by leadership, clinical support roles, hours of operation, total areas, and non-direct reports, but not by raw span or time in staff contact. Large acute care hospitals can improve satisfaction with supervision and teamwork by modifying first-line management positions.

This thesis is about collaborative activities in interactive spaces. These spaces are characterized by having shared, large displays in combination with private displays and software tools that facilitate a fluent sharing of information between people and their resources. The aim is to understand the collaborative activities in interactive spaces in terms of how team members are allowed to contribute to the overall work and what influence the physical qualities of space have on the collaboration. The research questions focus on the ways team members come to contribute to the work, how roles and functions are handled during collaboration, and how the physical qualities of the space influence the collaborative activities. To investigate these issues two empirical studies were conducted. The first study focused on two student teams that carried out conceptual design activities. The second study focused on geographically distributed meetings of an international research network. Data was mainly collected using video recordings, observations and questionnaires. The analyses are primarily based on detailed investigations of video recordings. The results showed in the first study that the large, touch-sensitive displays made it possible for the team members to interact and contribute to the work in several ways, which led to more equalized roles. In the second study the setting was more complex; the use of both video- and audio conferences made it difficult for the team members to overview the situation and to take part in the conversations, and their roles became more accentuated. It was further found that the physical- and the social space were intertwined: they appeared as spaces within spaces. The team members were also in a concrete sense constructing spaces within spaces: they created their own spaces in the common space and they often made transitions between shared and private, focal and peripheral work.

This report presents research study conducted at Linkoping University on coordination and logistics training design in simulation based environment.This study is based on C3Fire simulation environment for designing scenarios and simulations to train people for coordination and logistics handling under emergency situations. Related existing literature and theories about decision making, teamwork and situation awareness are studied and consulted to design new scenarios. Several scenarios were developed and initial experiments were conducted on these scenarios to check whether they meet intended behavior or not. Result of experiments proved success of scenario‟ design and these scenarios along their training goals, player and manager instructions are documented in report. It can be used to train and test team‟s ability for coordination and logistics aspects in emergency situations. Exhaustive testing of scenarios on large experiment base is left as future work.

Syftet med studien är öka kunskapen om sjukhuskuratorns profession och kurativt arbete inom geriatrisk vård. För att uppfylla syftet har jag utgått från följande frågeställningar: Vad kännetecknar kuratorns arbete inom geriatrisk vård, vilken kompetens behövs för kurativt arbete inom geriatrisk vård, hur upplever sjukhuskuratorn sin yrkesroll i teamwork, och vilka faktorer gynnar känslomässiga svåra situationer. Studien bygger på kvalitativ metod med fem individuella intervjuer med sjukhuskuratorer verksamma inom geriatrisk vård. Intervjuerna gjordes utifrån en semistrukturerad frågeguide som utgick från teman. Resultatet visar att vara kurator inom geriatrisk vård innebär egentligen att arbeta med hela samhället. Det är ett enormt brett och tungt arbete men också med mycket glädje. Det som kuratorsarbetet syftar till, är att stödja patienten och de anhöriga genom att försöka förmå den äldre patienten och de anhöriga att orka leva så normalt som möjligt. Det är viktigt att kuratorn känner sig delaktiga i ett teamwork. Personalen som består av olika professioner arbetar i team. Kuratorn utgör den psykosociala kompetensen inom teamet, med kunskaper rörande samspelet mellan äldre patient och anhörigas psykiska och sociala situation. Kurator ansvarar för att dessa aspekter hos patienter och anhöriga intresserades och på lämpligt sätt utföras i geriatriska vården. Kuratorns utvecklingsmöjligheter finns det men beroende på i vilken organisation man tillhör har avgörande roll. Det är en fördel att arbeta som kurator med äldre patienter är att kuratorn har största möjliga tillgång till livsberättelser från levande människor.