Increased quality and efficiency in healthcare chains

The overall aim of the project is to create new knowledge on how efficiency and quality in the healthcare chain can be improved with a specific focus on leadership, continuity of care, safety culture, learning and team collaboration.

Varmt omhändertagande

Project description

Severely ill patients are moved several times in the care chain, which can be stressful and associated with risks for both patients and staff. The project is run as an interdisciplinary project between the subjects of nursing sciences and quality management to create new approaches to achieve the purpose of the project. The project’s methodological approach is case studies and action research as the empery will be collected in the participating organisations. The project is based on an interactive and inclusive approach where the project group continuously tests and evaluates working methods and metodologies together with the participating organisations. By using managers and employees needs for coaching, patients and relatives’ perception of value creation, reasons for reintroductions at ICU and undesirable events in connection with transfers, the project will generate the basis for securing also other care chains. There is currently very limited research in the field and the project has an organizational, economic and ethical value as well as a social value. In order for healthcare to use its resources in the best possible way, the processes available need to be ensured to provide the best possible value for patients, relatives and society at large.

Benefits for the society

The preparations and organisation in connection with a patient transfer from ICU to the general ward are of great importance for relatives as well as for the transferee, but also for the healthcare economy as an ICU is expensive and places few. This project intends to provide new knowledge about how care chains can be improved and made safer and more efficient. Severely ill patients are moved several times in the care chain, which can be stressful for patients and relatives, but also for the healthcare employees. Healthcare has limited resources at the same time responsibility for good, safe but also person-centered care where both patients and relatives are given the opportunity to participate. For patients, there is also a risk associated with transfer, as a reinstatement at ICU after being transferred means increased mortality.

Partner organisations

The project partners are County Council Region Västernorrland, and Region Jämtland-Härjedalen.The project members have visited Tampa General Hospital to learn and be inspired. Tampa General Hospital has been awarded the Magnetic Hospital, which is a testament to their successful quality work. Different patient associations will also be asked as a reference group.

Results so far

Initially, a systematic literature review was conducted to explore how the research areas Quality Management and Nursing Science can contribute with complementary perspectives, in order to create an improved quality of care during patient transfers from ICU to general ward. The study of scientific articles within ICU Transitional Care showed that core values, methods and improvement tools from Quality Management are used in patient transfers from ICU to the care unit. By combining the perspectives from the two research subjects, one can gain a deeper understanding of how the current process can be improved.The study also showed in two areas where further research is needed, which are leadership and team collaboration within patient transfers from IVA to care departments.

This literature review has now been published as an article in the journal International Journal of Service Sciences and can be seen here. 

Several different activities have been carried out so far in the project:

  • Surveys and focus groups interviews to identify how employees perceive the patient transfer process today and how they wish a future process would be for increase quality of care and patient safety.
  • A measurement tool in the form of a survey has been developed to measure team collaboration in the process of patient transfers. Measurements using the tool have also been carried out and analysed.
  • A survey and analysis of suggestions for improvement has been establish together with employees working in the process.
  • A survey and analysis of the quality culture has been carried out in the studied context.
  • A plan for how Value Flow Mapping can help businesses understand how the process of patient transfers can be improved.

Project leader

Project members

Marie Häggström

Prefekt |Head of Department


Pernilla Ingelsson

Universitetslektor|Senior Lecturer


Lilly-Mari Sten

Doktorand|Doctoral Student