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Understanding How to Improve Team Collaboration Within Intensive Care Unit Transitional Care from the Perspective of Quality Management

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Understanding How to Improve Team Collaboration Within Intensive Care Unit Transitional Care from the Perspective of Quality Management Understanding How to Improve Team Collaboration Within Intensive Care Unit Transitional Care from the Perspective of Quality Management Lilly-Mari Sten Main supervisors: Associate Professor Pernilla Ingelsson Co-supervisor: Associate Professor Marie Häggström Faculty of Science, Technology and Media Thesis for Licentiate degree in Quality Technology Mid Sweden University Sundsvall/Östersund, 2021-06-16 Akademisk avhandling som med tillstånd av Mittuniversitetet i Östersund framläggs till offentlig granskning för avläggande av licentiatexamen onsdagen, 16 juni 2021, kl. 9:30, Q221/Zoom, Mittuniversitetet Östersund. Seminariet kommer att hållas på svenska. Understanding How to Improve Team Collaboration Within Intensive Care Unit Transitional Care from the Perspective of Quality Management © Lilly-Mari Sten, 2021-06-16 Printed by Mid Sweden University, Sundsvall, Sweden ISSN: 1652-8948 ISBN: 978-91-89341-10-4 Faculty of Science, Technology and Media Mid Sweden University, SE-831 25 Östersund Phone: +46 (0)10 142 80 00 Mid Sweden University Licentiate Thesis 182 “If everyone is moving forward together, then success takes care of itself.” Henry Ford Acknowledgement This thesis has been another step toward reaching one of my goals, and this far it has certainty been a wonderful journey of knowledge. I love this! First, I would like to thank my main supervisor Pernilla Ingelsson for her professional guidance and support along the path of writing this thesis. I also want to express my appreciation to my co-supervisor Marie Häggström for her wisdom and advice. In addition to these two strong women, I want to thank Ingela Bäckström, who leads the project of which I am a part. My gratitude goes to the Kamprad Family Foundation that made this project and the licentiate studies possible through its funding. Ingela, Pernilla, Marie, and I have shared many great memories, insights and laughs during this project. Don’t forget our glasses in Torpshammar! I would also like to thank all of my colleagues at the Department of Quality Management; you are so nice and caring, always thinking of how to do things better and support each other. I also want to thank the co-workers and leaders from the organizations that made this thesis possible for taking their time for interviews and to answer questionnaires. Their contributions have been of great value to the result of this thesis. Finally, I want to thank my family and friends for always listening and giving their advice. Andreas, you are my personal adviser and always make me smile. You are there for me when I need it (and otherwise too). Simon and Alva, you are my wonderful children, always humble, and despite your youth are filled with knowledge of life and the world. Elsa and Algot you are awesome. I love you all! Lilly-Mari Sten Sundsvall, May 2021 Table of Contents Abstract ............................................................................................................... x Summary in Swedish ...................................................................................... xiii List of Papers .................................................................................................... xv 1 Introduction ...................................................................................................... 1 1.1 Background .................................................................................................... 1 1.2 Purpose and Research Questions .................................................................. 3 1.3 Connections Between Studies, Papers, and Research Questions ................. 3 1.4 Structure of the Thesis ................................................................................... 4 2 Theoretical Frame of Reference ..................................................................... 5 2.1 The Concept of Quality ................................................................................... 5 2.2 The Concept of Quality Management ............................................................. 6 2.3 The Development of Quality Management ..................................................... 7 2.4 Quality Management Core Values and Core Competencies in Health Care .. 8 2.5 Quality Management, Team Collaboration, and System Thinking ................. 9 2.6 The Concept of Teams and Team Collaboration in Health Care .................. 10 2.7 ICU Transitional Care ................................................................................... 12 3 Research Methodology ................................................................................. 13 3.1 Purpose of the Research .............................................................................. 13 3.2 Research Approach ...................................................................................... 13 3.2.1 Qualitative, Quantitative, and Mixed Methods ................................... 13 3.2.2 Induction, Deduction, and Abduction ................................................. 14 3.2.3 Quality Management and Nursing Science ........................................ 14 3.2.4 Philosophical World View ................................................................... 15 3.2.5 Research Design ............................................................................... 16 3.2.6 Research Methods ............................................................................. 17 3.2.7 Pre-Understanding ............................................................................. 18 3.3 My Research Journey ................................................................................... 19 3.4 The Research Process ................................................................................. 21 3.4.1 Study I—Systematic Literature Review .............................................. 21 3.4.2 Cases for Analysis in Study II and Study III ....................................... 22 3.4.3 Study II—Development of a Measurement Instrument ...................... 22 3.4.4 Study III—Focus group discussions (FGDs) ...................................... 24 3.5 Trustworthiness ............................................................................................ 25 3.5.1 Validity and Reliability in Questionnaires ........................................... 27 3.5.2 Generalizability .................................................................................. 28 vii 3.6 Ethics ............................................................................................................ 28 4 Summary of Appended Papers .................................................................... 30 4.1 Paper A ......................................................................................................... 30 4.1.1 Background ........................................................................................ 30 4.1.2 Purpose .............................................................................................. 30 4.1.3 Methodology ...................................................................................... 30 4.1.4 Main Findings ..................................................................................... 31 4.2 Paper B ......................................................................................................... 31 4.2.1 Background ........................................................................................ 31 4.2.2 Purpose .............................................................................................. 32 4.2.3 Methodology ...................................................................................... 32 4.2.4 Main Findings ..................................................................................... 32 4.3 Paper C ........................................................................................................ 33 4.3.1 Background ........................................................................................ 33 4.3.2 Purpose .............................................................................................. 33 4.3.3 Methodology ...................................................................................... 33 4.3.4 Main Findings ..................................................................................... 34 5 Connecting the Research Questions and Overall Purpose ....................... 35 5.1 Connecting the Conclusions to Research Question I ................................... 35 5.2 Connecting the Conclusions to Research Question II .................................. 35 5.3 Connecting the Conclusions to Research Question III ................................. 36 5.4 Connecting the Conclusions to Research Question IV ................................. 37 5.5 Connecting the Main Conclusions to the Overall Purpose ........................... 37 5.6 Practical Implications .................................................................................... 39 5.7 Contribution to New Knowledge when Two Scientific Fields Meet ............... 39 6 Discussion and Future Research ................................................................. 40 6.1 Overall Discussion of Results ....................................................................... 40 6.2 Methodological Discussion ........................................................................... 42 6.3 Future Research ........................................................................................... 43 7 List of References ........................................................................................
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