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Adopting standardized cancer patient pathways as a policy at different organizational levels in the Swedish health system
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0003-3503-7164
Umeå University, Faculty of Social Sciences, Department of Sociology.ORCID iD: 0000-0003-1975-9060
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-5203-9877
Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.ORCID iD: 0000-0003-0661-8269
2023 (English)In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 21, no 1, article id 122Article in journal (Refereed) Published
Abstract [en]

Background: Standardized cancer patient pathways as a new policy has been adopted in healthcare to improve the quality of cancer care. Within the health systems, actors at different levels manage the adoption of new policies to develop healthcare. The various actors on different levels play an important role and influence the policy adoption process. Thus, knowledge about how these actors use strategies when adopting cancer patient pathways as a policy in the health system becomes central.

Method: The study's aim was to explore how actors at different organizational levels in the health system adopted cancer patient pathways. Our overarching case was the Swedish health system at the national, regional, and local levels. Constructivist Grounded Theory Method was used to collect and analyze qualitative interviews with persons working in organizations directly involved in adopting cancer patient pathways at each level. Twelve individual and nine group interviews were conducted including 53 participants.

Results: Organizational actors at three different levels used distinct strategies during the adoption of cancer patient pathways: acting as-missionaries, fixers, and doers. Acting as missionaries consisted of preaching the idea of cancer patient pathways and framing it with a common purpose to agree upon. Acting as fixers entailed creating a space to put cancer patient pathways into practice and overcome challenges to this. Acting as doers comprised balancing breadth and speed in healthcare provision with not being involved in the development of cancer patient pathways for the local context. These strategies were not developed in isolation from the other organizational levels but rather, each level interacted with one another.

Conclusions: When adopting new policies, it is important to be aware of the different strategies and actors at various organizational levels in health systems. Even when actors on different levels developed separate strategies, if these contribute to fulfilling the four domains of inter-organizational collaboration, they can work well together to adopt new policies. Our study highlighted that the application of two domains was lacking, which meant that local actors were not sufficiently involved in collaboration, thus constricting the local use and optimization of cancer patient pathways in practice.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 21, no 1, article id 122
Keywords [en]
Collaboration, Grounded theory method, Health systems, Organizational levels, Organizational policy, Primary health care, Strategies
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:umu:diva-217363DOI: 10.1186/s12961-023-01073-8PubMedID: 38012670Scopus ID: 2-s2.0-85177861191OAI: oai:DiVA.org:umu-217363DiVA, id: diva2:1815955
Funder
The Kempe FoundationsRegion Västerbotten, RV-731891Region Västerbotten, RV-744851Region Västerbotten, RV-855211Region Västerbotten, RV-931881Region Västerbotten, RV-939898Visare Norr, 939897Visare Norr, 929986Visare Norr, 838121Cancerforskningsfonden i Norrland, LP-18–2193Available from: 2023-11-30 Created: 2023-11-30 Last updated: 2023-12-14Bibliographically approved

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Fjällström, PetterCoe, Anna-BrittLilja, MikaelHajdarevic, Senada

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CiteExportLink to record
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