Goals of telephone nursing work--the managers' perspectives: a qualitative study on Swedish Healthcare Direct.
BACKGROUND
Swedish Healthcare Direct (SHD) receives 6 million calls yearly and aims at increased public sense of security and healthcare efficiency. Little is known about what SHD managers perceive as the primary goals of telephone nursing (TN) work and how the organisation matches goals of health promotion and equitable healthcare, so important in Swedish healthcare legislation. The aim of the study was to explore and describe what the SHD managers perceive as the goals of TN work and how the managers view health promotion and implementation of equitable healthcare with gender as example at SHD.


METHODS
The study was qualitative using an exploratory and descriptive design. All 23 managers employed at SHD were interviewed and data analysis used deductive directed content analysis.


RESULTS
The findings reveal four themes describing the goals of TN work as recommended by the SHD managers. These are: 'create feelings of trust', 'achieve patient safety', 'assess, refer and give advice', and 'teach the caller'. Most of the managers stated that health promotion should not be included in the goals, whereas equitable healthcare was viewed as an important issue. Varying suggestions for implementing equitable healthcare were given.


CONCLUSIONS
The interviewed managers mainly echoed the organisational goals of TN work. The managers' expressed goal of teaching lacked the caller learning components highlighted by telenurses in previous research. The fact that health promotion was not seen as important indicates a need for SHD to clarify its goals as the organisation is part of the Swedish healthcare system, where health promotion should always permeate work. Time used for health promotion and dialogues in a gender equitable manner at SHD is well invested as it will save time elsewhere in the health care system, thereby facing one of the challenges of European health systems.
Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden. elenor.kaminsky@pubcare.uu.se.
Elenor
E
Kaminsky
Marianne
M
Carlsson
Inger K
IK
Holmström
Jan
J
Larsson
Mio
M
Fredriksson
D000328:Adult; D000368:Aged; D005260:Female; D006040:Goals; D006740:Hospital Administrators / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D036301:Qualitative Research; D013548:Sweden; D055817:Telenursing / Q000458:organization & administration*