title: Prerequisites for sustainable care improvement using the reflective team as a work model.
abstract: Several work models for care improvement have been developed in order to meet the requirement for evidence-based care. This study examines a work model for reflection, entitled the reflective team (RT). The main idea behind RTs is that caring skills exist among those who work closest to the patients. The team leader (RTL) encourages sustainable care improvement, rooted in research and proven experience, by using a lifeworld perspective to stimulate further reflection and a developmental process leading to research-based caring actions within the team. In order to maintain focus, it is important that the RTL has a clear idea of what sustainable care improvement means, and what the prerequisites are for such improvement. The aim of the present study is, therefore, to explore the prerequisites for improving sustainable care, seeking to answer how RTLs perceive these and use RTs for concrete planning. Nine RTLs were interviewed, and their statements were phenomenographically analysed. The analysis revealed three separate qualitative categories, which describe personal, interpersonal, and structural aspects of the prerequisites. In the discussion, these categories are compared with previous research on reflection, and the conclusion is reached that the optimal conditions for RTs to work, when focussed on sustainable care improvement, occur when the various aspects of the prerequisites are intertwined and become a natural part of the reflective work.
authors.affiliation: Academy of Care, Working Life and Social Welfare, University of Boras, Boras, Sweden; Lise-Lotte.Jonasson@hb.se.
authors.forename: Lise-Lotte
authors.initials: LL
authors.lastname: Jonasson
authors.affiliation: Academy of Care, Working Life and Social Welfare, University of Boras, Boras, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Carlsson
authors.affiliation: Academy of Care, Working Life and Social Welfare, University of Boras, Boras, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Nyström
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000592:standards*; D055318:Evidence-Based Nursing; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D010348:Patient Care Team / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Reflective team; care improvement; lifeworld; phenomenography; phenomenon; sustainability