A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
Journal article, 2024

Background: Consensus on priorities to optimize the sick leave and rehabilitation process (SRP) is lacking. Objective: To explore perspectives of stakeholders in the SRP on bridging the gap between desired process scope, and actual practice, from a multi-professional, multi-organizational, and interdisciplinary approach. Design and setting: Focus group interviews were conducted with various SRP frontline professionals in Region Västra Götaland, Sweden, using purposive sampling to capture a range of experiences. Participants discussed their perceptions of critical changes and priorities needed to meet patients’ SRP needs in a primary care context. All interviews were analyzed using systematic text condensation, as described by Malterud. Subjects: General practitioners (n = 6), rehabilitation coordinators and licensed healthcare professionals from primary healthcare (n = 13), administrators from the Social Insurance Agency, the Employment Agency and Social Services (n = 12). Results: Through data analysis, the following themes emerged: 1) The need for rules and regulations to enable coherent process governance 2) Challenges and opportunities in person-centered SRP: Professional collaboration, organizational priorities, and the need for enhanced leadership, and 3) Balancing resources and patient needs in the SRP: How to improve care quality and accessibility. In summary, participants mainly discussed how to improve process efficiency and quality of care while balancing available resources and a heavy workload. A main goal was to prevent negative spirals of suboptimal decision-making in individual cases, which could lead to increased work, unfortunate outcomes, and patient suffering. Conclusions: This qualitative study indicated that gaps between a desired process scope and actual practice might be bridged by enabling coherent cross-organizational process governance, prioritizing person-centered ways of working, and balancing available resources and workload. The above changes were believed to improve process quality and overall efficiency. Trial registration: The study project plan was pre-registered on September 21st, 2020, in the database FOU i VGR (researchweb.org), project number 274941.

patient care management

patient-centered care

sick leave

Primary health care

Sweden

Author

Märit Löfgren

University of Gothenburg

Region Västra Götaland

Karin Törnbom

University of Gothenburg

Daniel Gyllenhammar

Chalmers, Technology Management and Economics, Service Management and Logistics

Lena Nordeman

Region Västra Götaland

University of Gothenburg

Gun Rembeck

Region Västra Götaland

University of Gothenburg

Cecilia Björkelund

University of Gothenburg

Region Västra Götaland

Irene Svenningsson

Region Västra Götaland

University of Gothenburg

Dominique Hange

Region Västra Götaland

University of Gothenburg

Region Västra Götaland

Scandinavian Journal of Primary Health Care

0281-3432 (ISSN) 1502-7724 (eISSN)

Vol. In Press

Subject Categories

Health Care Service and Management, Health Policy and Services and Health Economy

DOI

10.1080/02813432.2024.2434123

PubMed

39623685

More information

Latest update

12/18/2024