Objectives  Previous studies have revealed a range of drug‐related problems for nursing home and hospital patients. Different attempts to reduce drug‐related problems have been tested. Medication reviews performed by pharmacists and subsequent presentation of findings at case conferences is one of these methods. Physicians' and nurses' experiences from multidisciplinary collaboration with pharmacists have to a lesser degree been investigated. This study aims to describe how Norwegian physicians and nurses experience collaborating with pharmacists at case conferences to reduce drug‐related problems in elderly patients. Methods  This was a qualitative interview study using systematic text condensation. The setting was nursing homes (long‐term care) and hospital wards (gerontology and rheumatology). Four physicians and eight nurses participated and the main outcome was physicians' and nurses' experiences of multidisciplinary collaboration with pharmacists. Key findings  Organizational problems were experienced including, among others, what professional contribution team members could expect from pharmacists and what professional role the pharmacist should have in the multidisciplinary team. Both professions reported that ambiguities as to when and if the pharmacist was supposed to attend their regular meetings resulted in some aggravation. On the other hand, the participants valued contributions from pharmacists with regard to pharmaceutical skills, and felt that this raised awareness on prescribing quality. Conclusions  Physicians and nurses valued the pharmacists' services and reported that this collaboration improved patients' drug therapy. However, before implementing this service in nursing homes there is a need to make an organizational framework for this collaboration to support the professional role of the pharmacist.

ObjectivesExternal inspections are widely used to improve the quality of care. The effects of inspections remain unclear and little is known about how they may work. We conducted a narrative synthesis of research literature to identify mediators of change in healthcare organisations subject to external inspections.MethodsWe performed a literature search (1980–January 2020) to identify empirical studies addressing change in healthcare organisations subject to external inspection. Guided by the Consolidated Framework for Implementation Research, we performed a narrative synthesis to identify mediators of change.ResultsWe included 95 studies. Accreditation was the most frequent type of inspection (n=68), followed by statutory inspections (n=19), and external peer review (n=9). Our findings suggest that the regulatory context in which the inspections take place affect how they are acted on by those being inspected. The way inspections are conducted seem to be critical for how the inspection findings are perceived and followed up. Inspections can engage and involve staff, facilitate leader engagement, improve communication and enable the creation of new networks for reflection on clinical practice. Inspections can contribute to creating an awareness of the inspected organisation’s current practice and performance gaps, and a commitment to change. Moreover, they can contribute to facilitating the planning and implementation of change, as well as self-evaluation and the use of data to evaluate performance.ConclusionsExternal inspections can affect different mediators of organisational change. The way and to what extent they do depend on a range of factors related to the outer setting, the way inspections are conducted and how they are perceived and acted on by the inspected organisation. To improve the quality of care, the organisational change processes need to involve and impact the way care is delivered to the patients.

The reflective practitioner may contribute to transform a consultation from repetitive patterns to a dialogue based on the patient's own coping resources.

ObjectivesTo explore the interactive process of sharing case stories in small-group activity in general practice.DesignQualitative focus group study.SettingPeer-group meetings of doctors attending specialist training or continuous medical education in general practice.ParticipantsTwenty female and 30 male doctors working in general practice in Norway.ResultsThe storyline of case presentations included detailed stories with emotional engagement, co-authored by other group members. The stories initiated discussions and reflections concerning patients’ and doctors’ perspectives, medical ethics as well as clinical problems. The safe atmosphere allowed testing out boundaries of socially shared knowledge.ConclusionsSharing case stories in small groups in general practice initiated interaction that facilitated meaning-making, reflection and peer support.

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