title: Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway.
abstract: Patient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories.
  
  
  
  A qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel.
  
  
  
  The LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers.
  
  
  
  As a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.
authors: NTNU Social Research, Dragvoll Allé 38b, N-7491, Trondheim, Norway. trond.kongsvik@iot.ntnu.no.|Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, NTNU, N-7491, Trondheim, Norway. trond.kongsvik@iot.ntnu.no.
authors: Trond
authors: T
authors: Kongsvik
authors: NTNU Social Research, Dragvoll Allé 38b, N-7491, Trondheim, Norway.
authors: Kristin
authors: K
authors: Halvorsen
authors: NTNU Social Research, Dragvoll Allé 38b, N-7491, Trondheim, Norway.
authors: Tonje
authors: T
authors: Osmundsen
authors: NTNU Social Research, Dragvoll Allé 38b, N-7491, Trondheim, Norway.
authors: Gudveig
authors: G
authors: Gjøsund
mesh_terms: D000288:Administrative Personnel; D001291:Attitude of Health Personnel; D003151:Community Health Centers / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D009664:Norway; D009735:Nursing Homes / Q000458:organization & administration* / Q000592:standards; D061214:Patient Safety; D010360:Patient Transfer / Q000592:standards*; D011320:Primary Health Care / Q000592:standards; D011785:Quality Assurance, Health Care
keywords: Competence; Local medical centres; Patient safety; Quality