Abstract
Purpose: The purpose of this study is to provide a review of the impact on culture (attitudes, values and assumptions) among both healthcare professionals, as well as users, when involving users for improving quality in healthcare.Methodology/Approach: The paper is based on an extensive, narrative literature review considering studies that included professional’s and users experiences of user involvement in quality improvement. The included articles were analyzed using an interpretive, along with a deductive, approach according to a theoretical framework.Findings: The results indicate that there is currently limited research focusing on the impact of user involvement in quality improvement processes regarding professionals’ and users’ attitudes, values and/or assumptions. The articles identified during the study provides situations and statements, during the process of development, which can be interpreted as change in the culture. Although few articles specifically draw conclusions on user involvement as a “tool” for cultural change, the authors interpret several findings which strengthens that theory.Research Limitation/implication: Research published in other databases could have been missed. The authors have tried to avoid this by using a snowball method reading references in identified articles.Originality/Value of paper: The review provides a platform for both future research and the development of current practice within the area. There have been literature reviews showing obstacles and enablers when using patients, users and relatives in quality improvement work, but few which investigates cultural change.
Highlights
Swedish healthcare, along with the western world healthcare systems in general, is currently facing major challenges and will probably not be able to produce enough healthcare in proportion to demand (Nordgren, 2009)
Given the purpose of this paper, to provide a review of the impact on culture among healthcare professionals, as well as users, when involving users for improving quality in healthcare, the results of this literature review contribute with several conclusions
Starting out from the initial hits with 3786 articles, in the end only six articles were found that covered this topic in a way that could be seen as a cultural change within the professional groups
Summary
Along with the western world healthcare systems in general, is currently facing major challenges and will probably not be able to produce enough healthcare in proportion to demand (Nordgren, 2009). The Swedish Association of Local Authorities and Regions (SALAR) (2010), stresses in a letter of intent that the higher level of education among patients, technology development, and the simple access to information tend to increase demand and expectations on healthcare services. Another trend that must be faced is that many people prefer and have come to expect a tailored solution in contact with service organizations (Quist and Fransson, 2014). Healthcare organizations are not generally structured to handle this demand for customization (Glouberman and Mintzberg, 2001a; SALAR, 2010)
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