Shared-decision making in designing new healthcare environments : ready to take off for improved quality

Background Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. Discussion This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. Summary We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users’ perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

Kreativitet under stress : En studie i att vara kreativ på beställning

En grafisk designer måste kunna producera oavsett vilka förhållanden som råder. Rapporten behandlar vad korta och långa deadlines har för inverkan på denna förmåga och hur kreativiteten kan främjas vid stressiga situationer. Semistrukturerade djupintervjuer utfördes med åtta Art- och Creative directors i Gävledala-regionen för att undersöka hur de upplevde att vara kreativa under stressiga förhållanden. Resultatet visade att det generellt inte var ett problem för studiens respondenter att vara kreativa på beställning men att de inte heller följde några specifika metoder för att underlätta arbetsflödet. Det visade sig även att det snarare var arbetsbördan och mängden arbetsuppgifter som påverkade stressfaktorn än en specifik tidsram.

Automatiserade regressionstester avseende arbetsflöden och behörigheter i ProjectWise. : En fallstudie om ProjectWise på Trafikverket

Test av mjukvara görs i syfte att se ifall systemet uppfyller specificerade krav samt för att hitta fel. Det är en viktig del i systemutveckling och involverar bland annat regressionstestning. Regressionstester utförs för att säkerställa att en ändring i systemet inte medför att andra delar i systemet påverkas negativt. Dokumenthanteringssystem hanterar ofta känslig data hos organisationer vilket ställer höga krav på säkerheten. Behörigheter i system måste därför testas noggrant för att säkerställa att data inte hamnar i fel händer. Dokumenthanteringssystem gör det möjligt för flera organisationer att samla sina resurser och kunskaper för att nå gemensamma mål. Gemensamma arbetsprocesser stöds med hjälp av arbetsflöden som innehåller ett antal olika tillstånd. Vid dessa olika tillstånd gäller olika behörigheter. När en behörighet ändras krävs regressionstester för att försäkra att ändringen inte har gjort inverkan på andra behörigheter. Denna studie har utförts som en kvalitativ fallstudie vars syfte var att beskriva utmaningar med regressionstestning av roller och behörigheter i arbetsflöden för dokument i dokumenthanteringssystem. Genom intervjuer och en observation så framkom det att stora utmaningar med dessa tester är att arbetsflödens tillstånd följer en förutbestämd sekvens. För att fullfölja denna sekvens så involveras en enorm mängd behörigheter som måste testas. Det ger ett mycket omfattande testarbete avseende bland annat tid och kostnad. Studien har riktat sig mot dokumenthanteringssystemet ProjectWise som förvaltas av Trafikverket. Beslutsunderlag togs fram för en teknisk lösning för automatiserad regressionstestning av roller och behörigheter i arbetsflöden åt ProjectWise. Utifrån en kravinsamling tillhandahölls beslutsunderlag som involverade Team Foundation Server (TFS), Coded UI och en nyckelordsdriven testmetod som en teknisk lösning. Slutligen jämfördes vilka skillnader den tekniska lösningen kan utgöra mot manuell testning. Utifrån litteratur, dokumentstudie och förstahandserfarenheter visade sig testautomatisering kunna utgöra skillnader inom ett antal identifierade problemområden, bland annat tid och kostnad.

Integrated Product Development in Truck Industry - A Case Study on Product Development Processes

This paper presents the result from a case study at Scania on product development processes. The objective with the case study was to gather information on Scania’s product development process (PDP) including the use of CAD and simulation tools, and project work. The objective was also to find any deviations or different interpretations among the employees on the PDP. To gather the information, semi-structured tape-recorded interviews have been used to ensure that individual interpretations from the interviewees could be gathered. Scania uses a defined and structured PDP which facilitates concurrent and cross-functional work. The PDP is implemented and followed to various degrees. The newly employed personnel may have difficulties with communication, both to find and to give information. Although, newly graduated personnel may find it easier to adapt to changes, and also to use a structured process which they have studied at universities. It was also known during the case study that the PDP is a major support for the newly employed personnel, which in turn decreases the time to get into the same working process as the more experienced personnel. Employees with decades of experience know the right sources from which to both give and gather information. Also, the terminology and definitions in the product development process may not be used as intended. This makes it difficult for other project members or teams who need to interpret the information received. At the same time, the routines among the more experienced personnel, which have been set-up throughout the years, make them more inflexible in adapting changes. The findings in the case study as well as challenges with implementing the PDP are known to Scania and are a part of the continuing work with improvement.

The attractiveness of the work is affected when production of handcrafted log houses moves indoors

Viewed from a historical perspective, a shift has occurred within the forestry and wood sector towards indoor work. In Sweden, the production of handcrafted log houses has now also begun to move indoors. With a point of departure in development processes within the log house sector involving working indoors, education, work attractiveness, between 2001-2005, the aim of this study was to compare indoor work with outdoor work, based on log house builders' experience of working on handcrafted log houses. Methods used in the interactive development project involving apprentices, experienced log house builders and researchers, were participation with continuous documentation of experiences and opinions; questions; interviews; and measurement of the work environment. The Attractive Work Model has been used in order to analyse perceptions and values. The changes, 15 out of 22 areas, were perceived both negatively and positively. Therefore, it can not be said that working on traditional, handcrafted log houses becomes more attractive if it is moved indoors. The majority wanted to work both outdoors and indoors, while most of the others only wanted to work outdoors. The results indicate that there is scope for developing more attractive work indoors by utilising experiences from log house builders and closely related activities such as the forestry and wood sector. Changes made within one area of work attractiveness affect other areas. Further research is needed both with regard to comparisons between indoor and outdoor work and regarding the interaction between the areas that are identified in the Attractive Work Model.

Processes of feelings in a society with a violent past : A qualitative study of the communication for Societal healing in the Truth Commissions in East Timor, Sri Lanka and Ghana between 2002-2011

The research investigates in what extent and how communication for meeting feelings is provided in Truth Commission work. It examines if and in what way feelings are addressed in the communication officially published by the Truth Commissions in East Timor, Ghana and Sri Lanka, occurring between 2002-2011. The research is also looking at the healing processes in a time perspective to find out if there is a communication for Societal healing to be continued in a longer term. My conclusion is that two cases of three in my research, the TRCs in Ghana and East Timor, have communication clearly directed to meet feelings caused by the war. One of the three cases (East Timor) has a communication with a clear ambition to heal over a longer period, to continue after the existence of the Truth Commission. The research suggests that communication with a clear ambition to reach out widely in the society, a communication directed to meet and process feelings over a longer period, can make Societal healing more effective. It also concludes that, in the future, Societal healing, as a field in conflict resolution, will be more based on representational media than today, provided through web communication.