Prioriteringsveiledere i spesialisthelsetjenesten

Aase-Kvåle, Irene; Magnussen, Anne-Mette; Nilssen, Even

doi:10.18261/issn.2464-3076-2019-03-03

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…Consequently, it is not a patient's right to access specialist care within the CPP time frames, even if the referral is classified as a CPP (Norwegian Directorate of Health, 2019b). The other deadline referred to in the statement is anchored in the priority-setting guidelines, which were introduced prior to the CPPs (from 2008-2012) to align professional discretion better with the overarching political and judicial principles for the prioritization of health care services (Aase-Kvåle et al, 2019). These guidelines specify which conditions give patients the right to specialist care and provide recommendations for the maximum deadlines to start treatment (Tranvåg et al, 2015).…”

Section: Referral Work: At What Point Is a Reasonable Suspicion Of Cancer Achieved?mentioning

confidence: 99%

CPP or Not, That Is the Question: Physicians’ Work With Activating CPPs

Næss

2021

Qual Health Res

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The Norwegian government has launched a policy titled cancer patient pathways (CPPs), which assigns maximum deadlines to the various phases of the diagnostic investigation. In this article, I examine the starting point of CPPs through the lens of institutional ethnography—that is, how physicians work with the referral of patients in the context of CPPs. Based on qualitative interviews with physicians in both primary and secondary care across Norway ( N = 37), the findings reveal that the distinction between CPP or not is by no means clear-cut for either primary or specialist physicians. The starting point of CPPs is mediated by the interaction between physicians and patients and how the referral is composed, as well as how and by whom the referral is interpreted, in conjunction with overarching discourses, policies, and guidelines for practice. The findings challenge the notion that all potential cancer patients can and should be equally prioritized.

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Section: Referral Work: At What Point Is a Reasonable Suspicion Of Cancer Achieved?mentioning

confidence: 99%

CPP or Not, That Is the Question: Physicians’ Work With Activating CPPs

Næss

2021

Qual Health Res

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“…Arbeidsgruppen påpeker at selv om det på overordnet nivå er bred enighet om målet om å redusere helserelatert fravaer fra arbeidslivet, er dette så langt i liten grad konkretisert i felles prioriteringer på tvers av helse-og arbeidsmarkedspolitikken. Prioritering av helsetjenester handler om hva som skal gjøres, og i hvilken rekkefølge, hva som er mulig å gjøre, og hva man har ressurser til å gjøre (Kvåle, Magnussen & Nilssen, 2019). I 2016-dokumentet påpekes viktigheten av at det gis samsvarende styringssignaler blant annet om samarbeidsavtaler og prioritering, at kommunikasjonslinjene mellom arbeids-og helsetjenestene styrkes, og at søkelyset på arbeid innen helsetjenestene må styrkes.…”

Section: Satsingens Problemrepresentasjonunclassified

“…Men bildet er ikke helt ensidig. I en undersøkelse av sykehusleger fant Kvåle et al (2019) at en kombinasjon av god kunnskap om de prioriterte retningslinjene og en positiv vurdering av revisjonen av retningslinjene var avgjørende for om retningslinjene påvirket legenes prioriteringspraksis. Det er også mer generelle studier som indikerer at leger i det store og hele ikke anser lovbestemmelsene som negative (Bjorvatn & Nilssen, 2018;Bringedal & Carlsen, 2018).…”

Section: Arbeid Er Helsefremmendeunclassified

Samarbeid arbeid og helse

Lundberg¹,

Magnussen²

2021

TFV

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Artikkelen stiller spørsmål om hvilke forståelser som ligger til grunn for myndighetenes problembeskrivelser og løsningsforslag på arbeid-helsefeltet. Den tar utgangspunkt i en pågående satsing mellom Helsedirektoratet og Arbeidsog velferdsdirektoratet om styrket samarbeid mellom helse-og velferdssektoren. Med utgangspunkt i Carol Bacchis «what is the problem represented to be»-tilnaerming gir vi en analyse av satsingen. Strategiens forutsetninger om arbeid som helsefremmende, og at prioriteringskriterier og veiledere styrer atferd, vies saerlig oppmerksomhet som illustrasjoner på at en bestemt problemrepresentasjon nødvendigvis skygger for andre forståelser og løsninger.

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Successfully changing the mode of regulation in clinical priority setting: how organisational factors contributed to establishing the Norwegian priority guidelines for specialist health care services

Aase-Kvåle

2023

HEPL

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This article investigates factors that contributed to the successful introduction of 33 priority guidelines for Norwegian specialist health care from 2008 to 2012. The guidelines constituted an important step in changing the regulation of clinical priority setting from largely self-regulation by medical professionals to a more centralised and hierarchical form, and therefore, resistance from the medical profession was expected. My focus is on organisational factors within the project that developed the guidelines, using policy documents and project documents as the main source of data. I find that the project was characterised by a high level of autonomy in terms of how it was organised and the actors included, with significant capacity for action in terms of both structure and personnel, and a broad inclusion of affected actors. The priority guideline project was dominated by medical professionals, and its organisation did not represent a radical break with established traditions of medical professional self-regulation. Although organisational autonomy, action capacity and broad inclusion were clearly of importance, the project's compliance with historical traditions and norms of medical governance stands out as the key factor in understanding the successful establishment of the priority guidelines.

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Prioriteringsveiledere i spesialisthelsetjenesten

Cited by 4 publications

References 25 publications

CPP or Not, That Is the Question: Physicians’ Work With Activating CPPs

CPP or Not, That Is the Question: Physicians’ Work With Activating CPPs

Samarbeid arbeid og helse

Successfully changing the mode of regulation in clinical priority setting: how organisational factors contributed to establishing the Norwegian priority guidelines for specialist health care services

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