Background: Implementing digital technology in home care services challenges care arrangements built on faceto-face encounters. Digital welfare technology has been suggested as a solution to increasing demands on health care services from an ageing population. Medication delivery is a major task for home care services, and digital medication devices could lessen the need for resources. But technology has scripts based on how designers picture its use, and these might not fit with users' needs and practices. New technology must go through processes of domestication among its users. In the present study, we investigate how health professionals experienced the implementation of a digital medication dispenser into home care services in Norway. Methods: This was a qualitative interview study with 26 health professionals from home care services in five municipalities. Results: All five municipalities had implemented a digital medication dispenser in home care services. Prior to the introduction of the dispenser, medication practices had been based on home visits. The safety of medication practices was the main concern of health professionals who had to negotiate the technological script in order to make it work in a new care arrangement. Rationalities of effectiveness collided with rationalities of care, symbolized by warm hands. Professionals who had been used to working independently became dependent on technical support. Being unfamiliar with the new medication arrangement led to resistance towards the digital dispenser, but more direct experiences changed the focus from technology to new care arrangements. Negotiating practical and organizational arrangements led health professionals to trust the digital medication dispenser to contribute to safe and good care for service users.
<p><em>Cooperation between third sector and municipal health care services – a qualitative study</em></p><p><em>Municipal health care services are facing challenges due to an increasing number of individuals in need of care, combined with demographic change. More unpaid voluntary work within health care services has been put forward as a solution. Cooperation between volunteers and municipal health authorities can be challenging. This qualitative interview study with seven volunteers and six health care service managers explore experiences with cooperation between third sector and health care services in seven Norwegian regional municipalities. Facilitators for cooperation were predictable economy, municipal coordination, recruitment of volunteers and personal engagement among cooperating parties. Lack of these factors hampered cooperation. Professional expectations towards volunteers were another challenge. In small communities local networks may contribute to recruitment of volunteers and simplify communication between parties. Cooperation towards a common goal may reinforce local identity. This article shows how such cooperation develops in-between formal and informal structures. </em></p>
Introduction: Norway introduced mandatory service agreements in 2012, as a reform instrument to strengthen partnerships between municipal care and hospitals. From the perspective of municipal care, lack of equality in these partnerships was prior to the reform perceived as an obstacle to collaboration. The study explores whether Norwegian municipalities perceive equality in these partnerships and improvement in collaboration, approximately 2 years after the reform was implemented.Theory/methods: Since we did not find any instrument to measure equality in partnerships, an explorative design was chosen. The development of the instrument was based on the theory on partnership and knowledge about the field and context. Then a national online survey was emitted to all 429 Norwegian municipals in 2013. The response rate was in total 58 percent (n=248). Mainly principal component analysis, ANOVA and descriptive methods have been applied.Results: It seems that the two dimensions "learning and expertise equality" and "contractual equality" collects reliable and valid data to measure aspects of equality in partnerships. Norwegian municipalities perceive equality in relation to hospitals on these dimensions. Some improvement of collaboration outcomes was found.
Discussion:Partnerships are usually based on voluntarism. The results indicate that statutory partnerships, within a public health care system, can be appropriate to equalize partnerships and improve collaboration between health care providers at different care levels.
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