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Fra begrensninger til mulighet.: Kan systemrevisjon som tilsynsmetode stimulere til systematisk forbedringsarbeid i kommunehelsetjenesten?
Nordic Council of Ministers, Nordic School of Public Health NHV.
Nordic Council of Ministers, Nordic School of Public Health NHV.
2005 (Norwegian)Independent thesis Advanced level (degree of Master (Two Years))Student thesisAlternative title
rom limitations to opportunity. : Does supervison carried out as system audits encourage systematic improvement efforts in municipal health services? (English)
Abstract [no]

Staten fører tilsyn med at kommunene i Norge oppfyller lovkrav som gjelder for kommunehelsetjenesten. Siden 1995 har tilsynsmetodikken i hovedsak vært systemrevisjon. I tillegg til at Fylkeslegen/Helsetilsynet i fylket kontrollerer at lovbestemmelser blir fulgt, er systemrevisjonene ment å bidra til systematisk forbedringsarbeid i kommunehelsetjenesten. Målsettingen med denne studien har vært å beskrive hvordan systemrevisjoner påvirker forbedringsarbeidet. Dette er en kvalitativ studie gjennomført som et case-study i to norske fylker. Datainnsamlingen ble gjort høsten 2001 gjennom dokumentgranskning og i fire fokusgrupper – to i hvert fylke. Det ble fokusert på hvilke forventninger 28 ansatte (14 ledere og 14 ”førstelinjepersonell”) i 19 ulike kommuner hadde til systemrevisjonene, hvordan resultatene var håndtert i kommunen og hvilken nytte de ansatte mente tilsynet hadde hatt. Resultatet viser at systemrevisjonene fikk fart på prosesser i kommunene. Tilsynet forarget noen og gledet andre. Hovedskillet går mellom et ønske om hjelp til faglig forbedring av helsetjenesten og ønsket om et friere kommunalt selvstyre. Det var tre forhold ved gjennomføringen av tilsynet som viste seg å være betydningsfulle med tanke på å bidra til systematisk forbedringsarbeid i kommunehelsetjenesten: språket/kommunikasjonen, individuell tilpasning og at kommunens øverste ledelse ble direkte involvert under tilsynsbesøket

Abstract [en]

Norwegian Board of Health controls that the municipal authorities in Norway fulfil their legal obligations as regards the municipal health service. Since 1995 system auditing has been the main method of supervision. In addition to Norwegian Board of Health in the Counties controlling that the legal obligations of the municipalities are upheld, system audits are meant to encourage systematic improvement efforts in the municipal health services. The aim of this essay has been to describe how the system audits affect improvement efforts. This is a qualitative study conducted as a case study in two Norwegian counties. Data collection was done during the autumn of 2001, by studying documents and in four focus groups – two in each county. The main focus was on what expectations 28 employees (14 leaders and 14 professionals) in 19 different municipalities had to the system audits, how the results were handled in the municipalities, and how useful the employees felt that the auditing had been. The results show that the system audits lead to greater activity in processes in the municipalities. The audits upset some and pleased others. The main differences were between a wish for more aid regarding professional improvements of the health service and a desire for greater municipal autonomy. Three areas of the audits were shown to be important for encouraging systematic improvement efforts in the municipal service: language/communication, individual adjustments, and that the municipality top management was directly involved during the audits.

Place, publisher, year, edition, pages
2005. , 51 p.
Series
Master of Public Health, MPH, ISSN 1104-5701 ; MPH 2005:38
Keyword [en]
Supervision, System Audit, Case-Study, Focus Groups, Improvement Efforts
Keyword [no]
Tilsyn, systemrevisjon, case-study, fokusgrupper, forbedringsarbeid
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3322OAI: oai:DiVA.org:norden-3322DiVA: diva2:733556
Presentation
2005-12-06, 13:00 (Norwegian)
Supervisors
Available from: 2014-07-10 Created: 2014-07-10 Last updated: 2014-07-10Bibliographically approved

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MPH 2005:38(585 kB)74 downloads
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CiteExportLink to record
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Citation style
  • apa
  • harvard1
  • ieee
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  • vancouver
  • Other style
More styles
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  • de-DE
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  • sv-SE
  • Other locale
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Output format
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