Expanding choice of primary care in Finland: much debate but little change so far

Tynkkynen, Liina‐Kaisa; Chydenius, Miisa; Saloranta, Anna; Keskimäki, Ilmo

doi:10.1016/j.healthpol.2016.01.015

Cited by 28 publications

(38 citation statements)

References 6 publications

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“…The 20 regional hospital districts provide specialized care. [12] The EHR coverage in Finland is 100 percent, and hospitals in Finland are fully digital. Paper records are no longer in use.…”

Section: Settingmentioning

confidence: 99%

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Health information systems´ usability-related use errors in patient safety incidents

Hautamäki¹,

Kinnunen²,

Palojoki³

2017

FinJeHeW

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Health information systems contain usability issues that cause use errors, which may pose a risk to patient safety. The aim of this study was to identify what kind of usability issues in information systems cause use errors that lead to patient safety incidents. Patient safety incidents reported into an incident reporting system in a Finnish hospital district during the year 2014 (n=2500) were analyzed from the perspectives of usability and use errors. An inductive content analysis was carried out in order to gather information about the usability issues that may have led to a use error, thus causing patient safety incidents. The results showed that the main usability issues are the distribution of information into multiple views, identification problems with the selected patient, and basic daily tasks' reliance on users' memory. The results show that the relationship between usability, use errors, and patient safety should be understood and considered in the health information system design.

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Section: Settingmentioning

confidence: 99%

“…Some models have been developed in order to identify and mitigate HIS usability issues that could potentially lead to patient harm [11,12]. Marcilly et al framework links up usability principles, usability flaws, use problems and their potential outcomes ( Figure 1) [11].…”

Section: Introductionmentioning

confidence: 99%

Health information systems´ usability-related use errors in patient safety incidents

Hautamäki¹,

Kinnunen²,

Palojoki³

2017

FinJeHeW

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“…Patient and public involvement has established its position on the policy agenda (Martin, ). In Finland, similar to numerous other western countries, policy makers have been promising to put people utilising health services “in the driver's seat” (Tynkkynen, Chydenius, Saloranta, & Keskimäki, ). This rhetoric has been particularly common in relation to health services, which are the focus of this study.…”

Section: Introductionmentioning

confidence: 99%

“…It has also been argued that business and economic interests have taken a guiding role in health policy (Ollila & Koivusalo, ). The Finnish healthcare system is complex with a highly decentralised administration, multiple funding sources, and three distribution channels in first contact care (Tynkkynen et al., ). On a primary care level, services can be accessed through municipal health centres, occupational health services or private services.…”

Section: Introductionmentioning

confidence: 99%

“The citizen is stepping into a new role”—Policy interpretations of patient and public involvement in Finland

Jones

Pietilä

2017

Health Soc Care Community

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Involving patients and the public in healthcare decision-making is on the policy agenda in several countries. The aim of our study was to describe and analyse the development of patient and public involvement from a policy perspective. We argue that the language of health policies can influence both the aims and the development of involvement methods. In this study health policy documents, which have guided the development of patient and public involvement in Finland have been analysed using methods of Membership Categorisation Analysis. This has enabled us to explore how health policy documents categorise patients and the wider public in relation to involvement and orientate the involvement activities in which people are able to participate. Different set of abilities, expectations, responsibilities and opportunities is attached to the categories of patient, risk group, service user, customer and expert. Health policy documents often equate involvement with choice making by service users and customers; or as involvement in service development by experts. In both of these cases, involvement is depicted as an individual activity that requires personal responsibility and specialist knowledge. Although involvement opportunities have overall increased, they are primarily available to people that are "participation ready" and able to adopt roles promoted in policies. Health policy documents produce one interpretation of involvement, nevertheless it is important that diverse groups of patients, the public and health professionals participate in the discussion and express their views, which may differ from those of policy makers.

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“…Currently, patients can choose a PHC centre with shorter waiting times which fits with the aim of the reform to improve access to PHC. 5,6,12,13 It is commonly known that patients with a chronic disease or multi-morbidity benefit from a care plan. 14,15 It is essential to tailor treatment for patients with complex care needs in order to ensure the continuity of the treatment.…”

Section: Introductionmentioning

confidence: 99%

How do health care workers manage a patient with multiple care needs from both health and social care services? – A vignette study

Vehko

Jolanki

Aalto

et al. 2017

International Journal of Care Coordination

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IntroductionTo assess how health care professionals outline the management of care and explore which health or social care professionals were involved in the patient's treatment.MethodsA survey with a patient vignette for general practitioners (n = 31) and registered nurses (n = 31) working daily in Finnish health centres located in four cities. Respondents answered structural questions and explained in detail the care process that they tailored for the patient. The care process was examined using content analysis.ResultsA physician–nurse working pair was declared to be in charge of the care process by 27% of respondents, a registered nurse by 9% and a general practitioner by 11%. However, 53% reported that no single person or working pair was in charge of the care process (response rate 72%). The concluding result of the analyses of the presented process was that both treatment practices and the professionals participating in the patient's treatment varied. Collaboration with social services was occasional, and few care processes included referrals to social services.ConclusionFor the patient who needs both health and social care services, the management of care is a challenge. To improve the chances of patients being actively involved in making treatment plans at least three factors need to be addressed. Firstly, a written treatment plan should explicate the care process. Second, collaboration and interaction between health and social care services should be strengthened, and third, a contact person should be named to avoid care gaps in primary health care. Next-step data from patients need to be collected to get their views on care management and compare these with those from general practitioners and registered nurses.

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Expanding choice of primary care in Finland: much debate but little change so far

Cited by 28 publications

References 6 publications

Health information systems´ usability-related use errors in patient safety incidents

Health information systems´ usability-related use errors in patient safety incidents

“The citizen is stepping into a new role”—Policy interpretations of patient and public involvement in Finland

How do health care workers manage a patient with multiple care needs from both health and social care services? – A vignette study

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