This paper sets out to describe challenges concerning the design of a new best practice using video conferencing indischarge planning sessions. A Participatory Action Research approach was used in the study. Data collection and analysiswere carried out through workshop discussions with professionals responsible for discharge planning in hospital and inhomecare. The results indicate challenges consisting of two main categories; need of knowledge and competence and needof support, that is of importance in developing new work practices for making the discharge planning session work outusing video conferencing in the planning session.

Implementering av sjuksköterskans kärnkompetenser är den tredje boken som handlar om sjuksköterskans kärnkompetenser. Boken vill inspirera alla som söker kunskap om hur sjuksköterskans kärnkompetenser kan implementeras i hälso- och sjukvården och äldreomsorgen. I bokens kapitel belyser författarna hur implementeringen av de sex kärnkompetenserna; personcentrerad vård, samverkan i team, evidensbaserad vård, förbättringskunskap, säker vård och informatik kan genomföras.

Boken bidrar med kunskap, handlingsberedskap och förståelse för att kunna möta och hantera dagens och framtidens krav på en kvalitativt god hälso- och sjukvård. I det inledande kapitlet presenteras begreppet implementering och implementeringsstrategi. I de kommande kapitel ges exempel på hur implementering av de sex kärnkompetenserna kan genomföras.

Boken är avsedd som kurslitteratur för studenter på grundläggande och avancerad nivå, men passar även kliniskt verksamma sjuksköterskor och andra yrkesverksamma inom hälso- och sjukvård.

Grundbok i eHälsa ger en inblick i områden som studenter inom hälso- och sjukvård behöver för att möta digitaliseringen. Genom att tillämpa en tvärvetenskaplig strategi för att beskriva digitaliseringen inom hälso- och sjukvården synliggörs komplexiteten i olika situationer när eHälsolösningar introduceras och implementeras.

Boken har tre delar. Den första, individperspektivet, fokuserar på etiska aspekter, evidens och patientsäkerhet, liksom vikten av att arbeta personcentrerat när individens vardag digitaliseras. Den andra, organisationsperspektivet, handlar om ledning och styrning. Den tar upp förändringskunskap, förändringsledning och hur införandeprocesser bör bedrivas för att bli framgångsrika. Den sista delen, samhällsperspektivet, behandlar ansvar, nytta och ekonomi på olika nivåer när verksamheter inom hälso- och sjukvården digitaliseras. Varje del tar avstamp i en exempelberättelse och avslutas med frågor för egna funderingar och samtal.

mHealth services are becoming common all over the world. However, the acceptance and use of mHealth services are not always as expected. In this paper, we discuss the lessons learned from our recently finished research project “Health in Hand”. Based on the Swedish case study on using mHealth services to support patients with Type 2 Diabetes (T2D) in living a healthy life, we propose strategies for engaging the end-users in mHealth services. These strategies include moving user-driven participation from the margin to the center, building up a professional education team to support both patients and healthcare providers, strengthening user motivation through gamification and supporting the sharing of knowledge within and between different user groups. We believe that these strategies could improve the design of mHealth services through higher user engagement.

Challenges of improving discharge planning have been an area of concern for many years, including problems related to the lack of time for professionals to participate. In a county in South East Sweden, video conferencing was implemented in discharge planning sessions to enable distance participation of the professionals. To examine the implementation process, interviews were conducted with the implementers, who were project leaders, discharge planning coordinators in the hospital, and in home-care. The interviews were analyzed qualitatively, using directed content analysis with a deductive approach to a theoretical framework that was composed from theories about implementation processes to be suitable for the healthcare sector, consisting of the factors: implementation objects; implementation actions; actors; users; inner context and outer context. The results of this study are consistent with the framework but with the addition of a new dimension – time, i.e. time to prepare; time to understand; time to run through and time to reflect. It is suggested that implementation frameworks are useful when IT is introduced in healthcare. Framing the implementation process supports the exposure of factors and highlights relationships and states of dependence between those factors which may affect implementation.

This article describes healthcare managers' experiences of leading the implementation of video conferencing in discharge planning sessions as a new tool in everyday practice. Data collection took place through individual interviews and the interviews were analyzed using qualitative content analysis with an inductive approach. The results indicate that managers identified two distinct leadership perspectives when they reflected on the implementation process. They described a desired way of leading the implementation and communicating about the upcoming change, understanding and securing support for decisions, as well as ensuring that sufficient time is available throughout the change process. They also, however, described how they perceived that the implementation process was actually taking place, highlighting the lack of planning and preparation as well as the need for support and to be supportive, and having the courage to adopt and lead the implementation. It is suggested that managers at all levels require more information and training in how to encourage staff to become involved in designing their everyday work and in the implementation process. Managers, too, need ongoing organizational support for good leadership throughout the implementation of video conferencing in discharge planning sessions, including planning, start-up, implementation, and evaluation.

The overall aim of this thesis has been to study the implementation process concerning the use of video conferencing in discharge planning, during and after a development project in a region in southeast Sweden. The research approach has been developed within a new interdisciplinary research area, Applied Health Technology. The main focus of the research has been on how the new IT solution has affected everyday work, and in what ways management supported staff during the implementation process. The study design has a qualitative approach. Phenomenological hermeneutics, content analysis and Participatory Action Research (PAR) have been used in the analysis process. Study I aimed to describe  primary healthcare nursing staff’s experiences of discharge planning, along with their concerns about using video conferencing in discharge planning sessions. It was found that there is need for improvement in communication and understanding between nursing staff working in hospitals and in primary healthcare, and need for nursing staff to obtain more information about how IT solutions could support their work. The aim of Study II was to examine the implementation process of using video conferencing in discharge planning, according to a theoretical framework composed from theories about implementation processes. It was found that implementation frameworks can be useful, and that framing the implementation process supports the exposure of factors and highlights relationships and states of dependency between those factors which may affect implementation. Study III set out to describe managers’ reflections about leading the implementation process of using video conferencing in the discharge planning session. The results indicate that managers experienced two leadership perspectives when they reflected on the implementation process. On one hand, they described a desired way of leading implementation, on the other hand they described an actual way of leading implementation. The aim of Study IV was to describe the reflections of professionals about what is needed in order to create what should become a new best practice using videoconferencing in the discharge planning sessions. The results indicate that the professionals experienced lack of knowledge and understanding about each other’s everyday work and that the absence of well-functioning common routines obstructed the process. The results also indicate that there is a lack of common arenas to enable discussions, negotiations and agreements about adopting new routines as the discharge planning process changes over time. This thesis contributes to the much-needed discussions about how to manage the many ongoing IT implementation processes in Swedish healthcare organizations, by highlighting challenges and difficulties that both healthcare professionals and managers have experienced during an implementation process. The results indicate that implementation frameworks can be useful when new IT solutions are introduced in healthcare, and that there is a need for dedicating time, space and support for involved professionals in designing their everyday work.