There is an increased need for complete medical device traceability in the healthcare industry. The two main reasons are the healthcare industry's global supply chain and decentralised adverse events reporting, where different laws apply for each country and where each country has their own database for incidents without international governance. The idea of improving traceability procedures in the surgical department at Karolinska University Hospital was formed in the light of a near miss event where guidelines regarding incident management of a Single-Use Medical Device (SUMD) were not followed properly. Hence, this thesis project will investigate the issue of finding an effective way to trace SUMDs at Karolinska University Hospital, in order to improve the incident management process and suggest improvements of patient safety at other Swedish hospitals as well. The collection of data consisted of different data sources; observations at the research site and interviews with relevant participants. By employing multiple sources to this study, a more holistic approach could be achieved. In addition to observing the current situation of device registration, it was of importance to ask individuals with competence and different perspectives on the issue of traceability of SUMDs. To answer the research questions, the acquired data was categorized into the different identified cornerstones of traceability of SUMDs. These were registration process, perioperative supply chain and incidents management. Each section was divided into an investigation of the current process, issues and suggested improvements, in order to clearly answer to the research questions. Furthermore, these acquired answers and insights, from observations and interviews, were translated and summarized to form a basis for the results. Based on the data acquisition and compilation from the different perspectives, key findings and themes are presented in the results. The thesis proposal include a visual representation that show the physical flow of a SUMD from the point of being delivered to the hospital by the distributor, through different entities where registration occur, until it is either discarded or saved for incidents reporting. In order to avoid many of the current issues and to realize the acquired suggestions from this thesis, interoperability between the systems within the healthcare organization as well as between the different entities throughout the entire supply chain is an essential part of the solution, which should be further studied.

Healthcare is a complex system under great pressure for meeting the patients’ needs. Implementing technology at inpatient wards might possibly support healthcare professionals and improve quality of care. However, these technologies might come with issues and the system might not be used as intended. This master thesis project investigates how healthcare professionals communicate at an inpatient ward and how this might be affected by implementing a Mobile Healthcare Solution (MHS). Further, it sought to question why healthcare professions might, or might not, use the MHS as a support of their daily work and what some reasons for this might be. Research methods were of qualitative approach. Field studies were performed at an inpatient ward and further, two healthcare professionals were interviewed. Grounded Theory (GT) was chosen as a method to process the data and obtain understanding for communication at the inpatient ward. The results showed that healthcare professionals communicate verbally, written and by reading, using different tools. The most prominent ways of communication were verbally, where it was common to report or discuss about a patient. The means for communication did not get drastically affected by implementing the MHS and reasons for this were of social, technical and organizational types. Some reasons for not using the MHS were habits and due to healthcare professionals perceiving the MHS as more time consuming than manual handling. However, a specific investigation of whether this might affect the usage of the MHS is yet needed

Major demographical changes, such as aging population, constantly increases the demand for healthand social care services and technologies. The concept of welfare technologies is a response to meet this demand, since it increases independency, activity, participation and safety for people that has or is at risk of developing a disability. The procurement process of welfare technology is described as ineffective and problematic and is one of the major bottlenecks in implementing this type of technology. The aim of this study was to explore how the practical procurement process of welfare technology is performed in Swedish municipalities, an area which is currently under-researched. Moreover, the main problematic areas in the procurement, and their causes were investigated, which was carried out through qualitative semi-structured interviews with municipal actors. Data was collected from 3 municipalities, with 8 interview participants in total. The collected data from these interviews was transcribed, using intelligent verbatim, and analyzed inductively in the framework of qualitative content analysis. The data analysis yielded 7 main categories of problematic areas in the procurement process, along with 47 sub-categories. The main issues discussed were related to insufficient resources, such as competence, time and money, too little focus on the userneed, and difficulties with integrating welfare technology with other technical systems. A set of concrete advices for how to target some of the identified problems was generated, along with a couple guidelines for how to streamline the procurement process of welfare technology. It is argued in this report that the municipal organization of this process needs to be looked over, which cannot solely occur within municipalities, but must also be decided from a higher political level.

Till följd av NPM (New public management) och de ökade kraven på produktivitet och effektivitet har sjuksköterskors arbetssituation försämrats alltmer under de senaste decennierna. Det har resulterat i en försämrad hälsa hos sjuksköterskorna och många sjuksköterskor har valt att lämna yrket. Det har bland annat genererat brist på erfarna sjuksköterskor på akutvårdsavdelningarna som bedrivs dygnet runt i regionerna och detta anser Socialstyrelsen utgöra ett hot mot patientsäkerheten. Ett bra verksamhetsnära ledarskap, i regionerna benämns dessa som första linjens chefer, är en betydande faktor för sjuksköterskors hälsa och vilja att stanna kvar på sin arbetsplats. Det är därför av intresse att undersöka vilka ledaregenskaper som krävs för att erfarna sjuksköterskor skall arbeta kvar på vårdavdelningar som är öppna dygnet runt. Syftet med studien är att utröna vad som är viktiga hörnstenar i det hälsofrämjande ledarskapet för att bibehålla erfarna sjuksköterskor i dygnet runt verksamhet. Som metod användes semistrukturerade kvalitativa intervjuer med en induktiv ansats, åtta intervjuer utfördes totalt. Råmaterialet analyserades med hjälp av innehållsanalys och meningsbärande enheter, koder, kategorier och teman identifierades. Resultatet utmynnade i tre teman: individuellt stöd, teamarbete och kommunikation. Informanterna lyfte bland annat individanpassade scheman, kompetensutveckling och temaarbete som viktiga aspekter för att kvarstanna på arbetsplatsen. Ett salutogent förhållningssätt och specifika hälsofrämjande ledarskapsegenskaper är grunderna för att bibehålla erfarna sjuksköterskor i verksamheter som bedrivs dygnet runt. Cheferna i en dygnet runt-verksamhet bör besitta följande förmågor: rak och tydlig kommunikation, förmåga att skapa tillit, vara lyhörda, kunna entusiasmera, prestigelöshet, vara drivna och målfokuserade samt inneha ett coachande förhållningssätt. Definition av erfarna sjuksköterskor, se sida 7 under Metod. / As a result of NPM (New public management) and the increased demands on productivity and efficiency, the work situation of nurses has deteriorated more and more in recent decades. This has resulted in a deterioration in the health of the nurses and a number of staff have chosen to leave the profession. Among other things, it has generated a shortage of experienced nurses in the Swedish emergency departments with twenty-four seven operations in the regions, and the Swedish National Board of Health and Welfare considers this to be a threat to patient safety. A leadership with the adjacent connection to the ward and the staff, are referred to as first-line managers in the Swedish regions. These mangers are significant factors for nurses' health and willingness to stay in their workplace. It is therefore of interest to investigate what leadership qualities are required for experienced1 nurses to continue working in wards that are open twenty-four seven. The purpose of the study is to find out what are important cornerstones in the health promoting leadership in order to retain experienced nurses in twenty-four seven operations. As a method, semi-structured qualitative interviews with an inductive approach were used, eight interviews were performed. The raw material was analyzed using content analysis and meaningful units, codes, categories and themes were identified. The result resulted in three themes: individual support, teamwork and communication. The informants highlighted, among other things, individualized schedules, skills development and team work as important aspects for staying in the workplace. The result was that specific health promoting leadership qualities and a salutogenic approach are the foundations for retaining experienced nurses in twenty-four seven operations. The managers in a twenty-four seven operations should possess the following abilities: straight forward and clear communication, the ability to create trust, be responsive, be able to enthuse, lack prestige, be driven and goal focused and have a coaching attitude. For a definition of experienced nurses, see page 7 under Method.

Bakgrund: Robotprocessautomation (RPA) är en automationsteknik som kan ersätta människors arbete i IT-system. RPA växer konstant och det finns förhoppningar om att den kan bidra med positiva effekter inom hälso- och sjukvård, bland annat genom att frigöra medarbetare till andra uppgifter och öka kvalitet i form av minskade fel. Det finns behov av fler konkreta exempel av RPA inom hälso- och sjukvården. Syfte: Studiens syfte var att undersöka effekter av RPA i en sjukhusmiljö, avseende: 1) kvalitet i form av minskade fel; 2) effektivitet i form av frigjord tid för medarbetare. Metod: En experimentell design användes med kvantitativ ansats, för att undersöka två fall på ett sjukhus: 1) RPA för att minska mänskliga fel i journalsystemets läkemedelslista. Antal och andel fel som korrigerades av RPA mättes. 2) RPA för att frigöra tid för medicinska sekreterare inom en arbetsprocess. Tidsåtgång att utföra den aktuella uppgiften mättes (14 mätningar fördelat på 4 sekreterare). Antal och andel fall som hanterades av RPA mättes. Ackumulerad besparad arbetstid för organisationen mättes, tillsammans med besparad heltidsekvivalent (HTE). Resultat: 1) RPA korrigerade mänskliga misstag i 68 % av fallen (n = 3179). 2) Den manuella processen tog 27 (24,5–30,5) sekunder att utföra (median och interkvartilavstånd). Under åtta månader hanterades 9956 fall av RPA, vilket innebar frigjord tid om 9,33 (8,47–10,54) arbetstimmar i månaden inom organisationen, motsvarande 5,3 (4,8–6,0) procent av en heltidstjänst. Slutsats: Studien visade på två fall som uppnådde önskade effekter, ett fall inom kvalitet och ett inom effektivitet. Fallen utgjorde även exempel på komplicerande faktorer, som att RPA endast är temporär lösning, samt komplexitet med att delad arbetsyta mellan människa och RPA. Resultatet kan inspirera andra organisationer samt bidra till en aggregerad kunskap för att skapa riktlinjer och standarder. / Background: Robotic Process Automation (RPA) is an automation technology that can replace human work in IT systems. RPA is a growing field, and there are hopes that it can contribute positive effects in healthcare, particularly by freeing up employees for other tasks and increasing quality by reducing errors. There is a need for more examples of RPA in healthcare. Objective: The aim of this study was to investigate the effects of RPA in a hospital environment, specifically regarding: 1) quality in terms of reduced errors, and 2) efficiency in terms of freed-up time for employees. Method: An experimental design with a quantitative approach was used to examine two cases in a hospital: 1) RPA to reduce human errors in the medication list of the electronic health record system. The number and percentage of errors corrected by RPA were measured. 2) RPA to free up time for medical secretaries in a specific workflow. The time required to complete the manual task was measured through 14 measurements involving 4 secretaries. The number and percentage of cases handled by RPA were measured. Accumulated saved working time for the organization was measured, along with the saved Full-Time Equivalent (FTE). Results: 1) RPA corrected human errors in 68% of cases (n=3179). 2) The manual process took 27 (24.5-30.5) seconds to complete (median and interquartile range). During eight months, RPA handled 9956 cases, resulting in a time savings of 9.33 (8.47-10.54) work hours per month within the organization, equivalent to 5.3 (4.8-6.0) percent of a full-time position. Conclusion: The study demonstrated two cases that achieved desired effects, one in terms of quality and one in terms of efficiency. The cases also presented complicating factors, such as RPA being a temporary solution and the complexity of shared workspace between humans and RPA. The results can inspire other organizations and contribute to aggregated knowledge for creating guidelines and standards.

Vi kommer presentera en kategoriserad och tematiserad översikt av faktorer som främjar/hindrar barns fysiska aktivitet utanför skolans ramar. Avsikten är att försöka göra en inventering av möjliga påverkansfaktorer för vår uppdragsgivare Innovation Skåne och förhoppningsvis skulle detta arbete kunna vara vägledande för dem. Syftet med detta arbete är att undersöka barns förutsättningar för fysisk aktivitet utanför skolans ramar. Metoden bestod av en litteraturstudie och barnintervjuer som genomgick tematisk analys. Sedan genomfördes en triangulering mellan de båda empiriska insamlingsmetoderna. Metoderna ställdes mot varandra för att se om barnens perspektiv från barnintervjuerna skiljde åt sig jämfört med forskning från litteraturen och de vuxnas perspektiv på barnens behov. Resultatet är att barnen har väldigt olika uppfattningar om vad fysisk aktivitet är, barnens perspektiv på fysisk aktivitet skiljer sig från forskningens breda definitioner i den utsträckning att sport, idrott och prestation är i fokus. Den tematiska analysens huvudområde och resultat berörde viktiga påverkansområden som möjliggörandet av självvalda aktiviteter och autonomi. Trygghet vid transporter med cykel, föräldranärvaro, gruppgemenskap eller självvald enskildhet i sin egen “bubbla” för att nämna några exempel. Slutsatsen är att det skiljer sig i barnrättsperspektivet gällande utemiljöer och möjligheterna som barnen har för att kunna ha någonstans att vara på efter skoltid eftersom skolorna inte är tillåtna att vistas på förens skoldagarna är slut när man går på högstadiet. Slutligen och också viktigast. Barn styr inte över sin fysiskt aktiva fritid. Det gör de vuxna. / We will be presenting a categorized and thematically analyzed overview of factors that facilitate/inhibit children's physical activity outside the context of compulsory school. The intent is to attempt to make an inventory of possible influencing factors for our client Innovation Skåne and it's our hope that this work could act as a guide in their work. The purpose of this work is to examine children's conditions for physical activity outside of school. The method consisted of a literature study and child interviews which underwent a thematic analysis. After which a triangulation was carried out between the two empirical collection methods. The methods were compared to each other to see if the children's perspective from the child interviews differ compared to the research from the literature and the adults' perspective on the children's needs. The result is that the children have very different perceptions of what physical activity is, the children's perspective on physical activity differs from the research's broad definitions to the extent that sports and performance are in focus. The main area and results of the thematic analysis touched on important impact areas such as the enabling of self-selected activities and autonomy. Safety when transporting by bicycle, parental presence, group community or self-selected privacy in your own "bubble" to name a few examples. The conclusion is that there is a difference in the children's rights perspective regarding outdoor environments and the opportunities that the children have to be able to have somewhere to be after school because the schools are not allowed to stay in until the school days are over when you go to upper secondary school. Last and most importantly. Children do not control their physically active free time. The adults do.

The aim behind this study was to observe and understand barriers to access the eHealth system equally. The study was conducted in Stockholm based on qualitative data in which semi- structured interviews were conducted among 15 interviewees from different localities of Stockholm. The findings from the collected data revealed that language barriers, lack of knowledge about digital literacy, unawareness of Swedish healthcare services, psychological and social barriers, safety and privacy concerns, and the lack of an e-identification are all major barriers to accessing the eHealth system. From the data, it has also been observed that the main causes of the aforementioned hurdles are based on varied socioeconomic levels, literacy conditions of an individual, cultural background, and age. Another important observation shows that highly qualified people with limited language abilities have a difficult time using eHealth services.

This paper aims to provide the grounds for a biopsychosocial understanding of the underpinnings of conspiracy theorist ideation by studying research articles from different scientific disciplines. Cross-disciplinary concurring results are presented and discussed, as well as some examples of how conspiracy theories have been used during the 20th century. Also discussed is how this is used in political discourse in the populist climate of today, with the rise of radical right-wing movements, the justification of “alternative facts” from higher governmental ranks, and religious fundamentalism, making it a societal issue of possible big magnitude. Neurological similarities was found between religiousness and proneness to conspiracy theory ideation, and the articles concerning neural correlates therefore stem from research on religious individuals due to the lack of neuro-biopsychological research on actual conspiracy theorists. Since conspiracy theory ideation has shown the ability to cause negative consequences it is also advised that governmental agencies and society as a whole revise its stance on populism and the spread of flawed information, in order to maintain an open society. Also presented are a few ideas on how to begin countering the rise of populism.

En god arbetsmiljö är avgörande för god hälsa. Sjukfrånvaron inom vårdrelaterade yrken blir allt högre samtidigt som antalet äldre personer i behov av hemtjänst förväntas öka med 76 procent till 2040 och antalet personer i yrkesverksam ålder förväntas öka med 9,4 procent. Därmed kan vi se att vård- och omsorgsorganisationer har en ökad risk för under bemanning och ökad personalomsättning på grund av den ökade belastningen inom yrkesgruppen. Utifrån detta ser vi att det är av vikt att studera första linjens chefer inom hemtjänsten och deras upplevelser kring den psykosociala arbetsmiljön. Syftet med denna studie är att undersöka hur första linjens chefer inom hemtjänsten handskas med den psykosociala arbetsmiljön genom att titta på chefernas förutsättningar för att arbeta med den psykosociala arbetsmiljön, studera deras upplevelser kring det stöd som de åtnjuter i arbetet med den psykosociala arbetsmiljön samt hur arbetet mot den ökande sjukfrånvaron ser ut. Datainsamling skedde via kvalitativ intervjustudie med induktiv ansats och data analyserades via tematisk analys. Resultatet visade att arbetet med den psykosociala arbetsmiljön i hemtjänsten är komplex och utmanande där första linjens chefer har stora personalgrupper som en försvårande faktor. Framgångsfaktorer som identifierades var närvarande ledarskap, låta medarbetare vara delaktiga i att planera tid för besök hos brukare, anpassning av arbetsuppgifter och fungerande stöd till chefer och medarbetare. Studiens resultat visar att första linjens chefer inom hemtjänsten har ett utmanande arbete med stora personalgrupper och höga krav på att hålla budget samtidigt som de ansvarar för arbetsmiljön och att det behövs omfattande arbete för att förbättra chefers förutsättningar och stöd. Studien bekräftar även tidigare forskning inom området och indikerar att det behövs ytterligare forskning inom området. / A good working environment is crucial for good health. The sick leave rate in healt care-related professions is increasing, while the number of elderly individuals in need of home care services is expected to increase by 76 percent, alongside a projected 9,4 percent increase in the working-age population. Consequently, we can observe that the healthcare organizations face an increased risk of understaffing and high turnover due to the growing demands in the profession. Based on this, it is important to study first-line managers in home care and their experiences with the psychosocial work environment. The aim of this study is to examine how first-line managers in home care manage the psychosocial work environment, by examining their prerequisites for addressing the psychosocial work environment, assessing how they experience the support they receive in this regard, and exploring the efforts made to combat increasing sick leave rates. Data collection was conducted through qualitative interviews using an inductive approach, and the data was analyzed using thematic analysis. The results revealed that the work concerning the psychosocial work in home care is complex and challenging, with the large size of the staff groups being a complicating factor. Success factors identified included present leadership, involving employees in planning time for client visits, task customization, and effective support for managers and employees. The result of the study shows that first-line managers in home care face challenging work with large staff groups and high demands to maintain the budget, while also being responsible for the work environment. There is a need for extensive efforts to improve managers conditions and support. The findings of the study also confirm previous research in the field and suggest the need for further research in this area.

Kommunen är huvudman för äldreomsorgen vilket innebär att organisationen är politiskt styrd. Att arbeta som första linjens chef inom äldreomsorgen är därmed ett komplext uppdrag där flera olika perspektiv konstant måste tas i beaktning. Första linjens chefer inom äldreomsorgen har krav på sig både uppifrån och nedifrån vilket kan skapa lojalitets konflikter. Förstalinjens chef står i direkt kontakt med den operativa verksamheten och dem verksamheten är till för (brukarna). Brukarnas och personalens intressen ska därmed pareras gentemot organisationens intressen och krav och det finns en relevans i att titta på hur eventuella lojalitetskonflikter hanteras och vilket handlingsutrymme första linjens chef har. Syftet med uppsatsen var att undersöka hur första linjens chefer upplever lojalitetskonflikter mellan verksamhetens uppdrag och arbetsgivaransvaret samt vilka strategier de använder i handlingsutrymmet. Studiens design var en kvalitativ intervjustudie med semistrukturerade frågor och materialet analyserades med hjälp av kvalitativ innehållsanalys. Dataanalysen resulterade i två huvudkategorier vilka var att leda genom lojalitet och att våga handla. Informanterna ansåg att deras lojalitet låg hos arbetsgivaren och att deras uppgift var att implementera politikers och lednings beslut. Informanterna var samtidigt tydliga med att brukarnas bästa kommer i första hand. De prioriterade och ignorerade vissa beslut utifrån om de kunde se ett tydligt syfte med arbetsuppgiften eller inte. Från NPM och detaljstyrning till dagens fokus på tillits- och värdebaserad styrning menar författarna att det är viktigt med chefers etiska kompetens eftersom de enligt denna studie verkar genomföra beslut baserat på om de själva finner syfte och värde i verksamheten de leder. / Swedish elderly care is a politically controlled organizationwith the municipality as principal. Working as a first-line manager in elderly care is thus a complex task where several different perspectives must constantly be taken into account. First-line managers have demands on them both from above and below, which can create loyalty conflicts. The first-line manager is in direct contact with the operational activities and those the activities are for (the users). The interests of the users and the staff must be balanced against the interests and demands of the organization and the reis a relevance in looking at how potential conflicts of loyalty are handled and what margin for manoeuvre the first-line manager has. The purpose of the essay was to investigate how first-line managers experience loyalty conflicts between the organizations mission and the employer's responsibility and which strategies they use in the margin for manoeuvre. The design of the study was a qualitative interview study with semistructured questions and the material was analyzed using qualitative content analysis. The data analysis resulted in two main categories which were leading through loyalty and daring to act. The informants believed that their loyalty lay with the employer and that their task was to implement the decisions of politicians and management. At the same time, the informants were clear that the best interests of the users come first. They prioritized and ignored certain decisions based on whether or not they could see a clear purpose for the work task. From NPM and detailed management to today's focus on trust and value-based management, the authors believe that managers' ethical competence is important because, according to this study, the managers seem to implement decisions based on whether they themselves find purpose and value for their operation unit.