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Skövde, Sweden

Yet B.,Chalmers University of Technology | Bastani K.,Chalmers University of Technology | Raharjo H.,Chalmers University of Technology | Lifvergren S.,Skaraborg Hospital Group | And 2 more authors.
Decision Support Systems | Year: 2013

Warfarin therapy is known as a complex process because of the variation in the patients' response. Failure to deal with such variation may lead to death as a result of thrombosis or bleeding. The possible sources of variation such as concomitant illnesses and drug interactions have to be investigated by the clinician in order to deal with the variation. This paper describes a decision support system (DSS) using Bayesian networks for assisting clinicians to make better decisions in Warfarin therapy management. The DSS is developed in collaboration with a Swedish hospital group that manages Warfarin therapy for more than 3000 patients. The proposed model can assist the clinician in making dose-adjustment and follow-up interval decisions, investigating variation causes, and evaluating bleeding and thrombosis risks related to therapy. The model is built upon previous findings from medical literature, the knowledge of domain experts, and large dataset of patients. © 2012 Elsevier B.V.

Bergman B.,Chalmers University of Technology | Bergman B.,Meiji University | Hellstrom A.,Chalmers University of Technology | Lifvergren S.,Chalmers University of Technology | And 3 more authors.
Quality Engineering | Year: 2015

Bo Bergman, Andreas HellstroÁm, Svante Lifvergren, and Susanne M. Gustavsson, Centre for Healthcare Improvement, Chalmers University of Technology, thank Ronald Does, Joeren de Mast, and Marit Schoonhoven for their important complement to their paper titled'An Emerging science of Improvement in Health Care'. The authors agree that operations management is a discipline of great importance to a science of improvement in health care. They also believe that action research (AR) aiming for sustainable system changes and also providing a more beneficial context for process improvements is an important and fruitful way forward. AR is an approach to inquiry where the researcher(s) engage in collaborative communities with practitioners on an equal grounding. The role of the patient as a co-producer illuminates the importance of person-centered care, where patients and health care professionals collaborate on stated care plans. When the patient is included in the care plan as an equal partner there can be room for increased self-management and empowered patients contributing to safe care. In conclusion, the authors agree with Does and colleagues about the importance of operations management and its different practices.

Bergman B.,Chalmers University of Technology | Bergman B.,Meiji University | Hellstrom A.,Chalmers University of Technology | Lifvergren S.,Chalmers University of Technology | And 3 more authors.
Quality Engineering | Year: 2015

The purpose of this article is to describe the emerging science of improvement in health care and to add a perspective from the industrial quality improvement movement, the use of data from quality registers, and to give some personal reflections and suggestions. Furthermore, we want to introduce to the broader quality management community what is happening in health care with respect to quality improvement. We will discuss some of the challenges of the health care system and the current status of a science of improvement and give some suggestions for further improvements to the area.We discuss a possible extension of improvement knowledge and the theoretical and practical arsenal of a science of improvement, in particular, understanding variation and implications for the use of, for, example control charts. In addition, the normative side of a science of improvement is discussed. The article ends with some brief reflections of use for future research agendas. © 2015 Taylor and Francis Group, LLC.

Lifvergren S.,Skaraborg Hospital Group | Lifvergren S.,Chalmers University of Technology | Gremyr I.,Chalmers University of Technology | Hellstrom A.,Chalmers University of Technology | And 2 more authors.
Operations Management Research | Year: 2010

The Skaraborg Hospital Group (SkaS) has implemented a variety of quality management initiatives in the last 20 years in accordance with its strategy of excelling at quality development to fulfill the needs and expectations of its patients. One such initiative is Six Sigma, which has contributed to more than 40 completed improvement projects. Using an action research approach, this article describes the lessons that were learned from the first 22 Six Sigma projects, completed between 2006 and 2008 and having a success rate of 75%. We further describe how these insights have contributed to other ongoing quality improvement activities at SkaS. In particular, the paper presents some key points not earlier described in other Six Sigma healthcare applications. © 2010 Springer Science+Business Media, LLC.

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