
Charting the Course Together: Municipal Top-Level Managers’ Perspectives on Fostering Safe and Integrated Care for Older Adults Living at Home
References
- Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37–43. DOI: 10.1016/S0140-6736(12)60240-2
- World Health Organization. Noncommunicable diseases. [webpage on the internet]. [cited 2024 May 28; updated 2023 Sep 16]. Available from:
https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases - Agerholm J, Pulkki J, Jensen NK, Keskimäki I, Andersen I, Burström B, et al. The organisation and responsibility for care for older people in Denmark, Finland and Sweden: outline and comparison of care systems. Scandinavian Journal of Public Health. 2024;52(2):119–22. DOI: 10.1177/14034948221137128
- Anell A, Glenngård AH, Merkur S. Sweden health system review. Health Systems in Transition. 2012;14(5):1–159.
https://iris.who.int/bitstream/handle/10665/330318/HiT-14-5-2012-eng.pdf?sequence=5&isAllowed=y - Janlöv N, Blume S, Glenngård AH, Hanspers K, Anell A, Merkur S. Sweden: Health System Review 2023. Health Systems in Transition. 2023;25(4):1–236.
https://eurohealthobservatory.who.int/publications/i/sweden-health-system-review-2023 - World Health Organization. Framework on integrated, people-centred health services: report by the Secretariat. Geneva: World Health Organization; 2016. [cited 2024 Feb 05]. Available from:
https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_39-en.pdf - Cline DD. A Concept Analysis of Vulnerability During Transitions. Nursing Education Perspectives. 2016;37(2):91–6.
- Karam M, Chouinard MC, Poitras ME, Couturier Y, Vedel I, Grgurevic N, Hudon C. Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review. International Journal of Integrated Care. 2021;21(1):
16 . DOI: 10.5334/ijic.5518 - Statistiska centralbyrån. Sökfunktion för yrke [Search function for profession]. [webpage on the internet].[cited 2024 May 28; updated 2014 Jan]. Available from:
https://www.h5.scb.se/yreg/ssyk2012.asp [in Swedish]. - Briggs AM, Valentijn PP, Thiyagarajan JA, Araujo de Carvalho I. Elements of integrated care approaches for older people: a review of reviews. BMJ Open. 2018;8(4):
e021194 . DOI: 10.1136/bmjopen-2017-021194 - Hendry A, Vanhecke E, Carriazo AM, López-Samaniego L, Espinosa JM, Sezgin D, et al. Integrated Care Models for Managing and Preventing Frailty: A Systematic Review for the European Joint Action on Frailty Prevention (ADVANTAGE JA). Translational Medicine UniSa. 2019;19(2):5–10
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581495/pdf/tm-19-005.pdf - Hughes G, Shaw SE, Greenhalgh T. Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts. Milbank Quarterly. 2020;98(2):446–92. DOI: 10.1111/1468-0009.12459
- Statens offentliga utredningar. God och nära vård – En reform för ett hållbart hälso- och sjukvårdssystem SOU 2020:19. [Good and close care – A reform for a sustainable health and healthcare system SOU 2020:19]. Stockholm: Socialdepartementet. 2020. [cited 2024 Feb 05] Available from:
https://www.regeringen.se/contentassets/320f37078d854712ab89e8185466817b/god-och-nara-vard-en-reform-for-ett-hallbart-halso--och-sjukvardssystem-sou_2020_19_webb.pdf [in Swedish]. - Myndigheten för vård- och omsorgsanalys. Läget för ledarna – Förutsättningar för ledarskapsutveckling i kommunal vård och omsorg. [The situation for leaders – Conditions for leadership development in municipal care and services]. Stockholm: Myndigheten för vård- och omsorgsanalys Report 2021;3. [cited 2023 Dec 14]. Available from:
https://www.vardanalys.se/rapporter/laget-for-ledarna/ . [in Swedish]. - Vision. Socialchefsrapporten 2023. [The Social Managers’ Report 2023]. Stockholm: Vision. 2023. [cited 2024 Mar 08] Available from:
https://vision.se/opinion/pressmeddelanden/2023/socialchefsrapporten-2023-dramatiskt-forsamrat-lage-for-landets-socialtjanster/ [in Swedish]. - Idsøe-Jakobsen I, Dombestein H, Wiig S. Exploring homecare leaders’ risk perception and the link to resilience and adaptive capacity: a multiple case study. BMC Health Services Research. 2024;14;24(1):
340 . DOI: 10.1186/s12913-024-10808-4 - Hagerman H, Engström M, Wadensten B, Skytt B. How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective? An interview study. Journal of Nursing Management. 2019;27(6):1208–1215. DOI: 10.1111/jonm.12793
- Strömberg A, Engström M, Hagerman H, Skytt B. First-line managers dealing with different management approaches. Leadership in Health Services. 2019;26;32(4):543–557. DOI: 10.1108/LHS-09-2018-0046
- Ward J, Bailey D. How far can a short leadership and management programme address the challenges for first line social work managers? An evaluation of one of the skills for care leadership and management demonstration sites. Practice. 2016;28(4):281–303. DOI: 10.1080/09503153.2015.1087492
- Exley J, Glover R, Mccarey M, Reed S, Ahmed A, Vrijhoef H, et al. Governing Integrated Health and Social Care: An Analysis of Experiences in Three European Countries. International Journal of Integrated Care. 2024;7;24(1):
9 . DOI: 10.5334/ijic.7610 - Sims S, Fletcher S, Brearley S, Ross F, Manthorpe J, Harris R. What does Success Look Like for Leaders of Integrated Health and Social Care Systems? A Realist Review. International Journal of Integrated Care. 2021;21(4):
26 , 1–17. DOI: 10.5334/ijic.5936 - Polit D, Beck C. Nursing Research: generating and assessing evidence for nursing practice. Eleventh edition. Philadelphia: Wolters Kluwer; 2021.
- Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6):349–57. DOI: 10.1093/intqhc/mzm042
- Evertsson P, Rosengren K. Political experiences of changing the focus in elderly care in one municipality. Journal of Nursing Management. 2015;23(8):994–1002. DOI: 10.1111/jonm.12245
- National Institutes of Health. NIH style guide Age. [webpage on the internet][Cited 2024 May 28; updated 2024 Jan 17]. Available from:
https://www.nih.gov/nih-style-guide/age - Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology. 2021;18(3):328–52. DOI: 10.1080/14780887.2020.1769238
- Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77–101. DOI: 10.1191/1478088706qp063oa
- NVivo QIPL. 2020. Available from:
https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home - World Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4. DOI: 10.1001/jama.2013.281053
- Zonneveld N, Raab J, Minkman M. Towards a values framework for integrated health services: an international Delphi study. BMC Health Services Research. 2020;20:
224 . DOI: 10.1186/s12913-020-5008-y - Swanson RC, Cattaneo A, Bradley E, Chunharas S, Atun R, Abbas KM, et al. Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change. Health Policy and Planning. 2012;27 Suppl 4(Suppl 4):iv54–61. DOI: 10.1093/heapol/czs090
- Lipsitz LA. Understanding health care as a complex system: the foundation for unintended consequences. JAMA. 2012;308(3):243–4. DOI: 10.1001/jama.2012.7551
- McNab D, McKay J, Shorrock S, Luty S, Bowie P. Development and application of ‘systems thinking’ principles for quality improvement. BMJ Open Quality. 2020;9(1). DOI: 10.1136/bmjoq-2019-000714
- Savigny Dd, Adam T,
Alliance for Health Policy and Systems Research & World Health Organization . Systems thinking for health systems strengthening/edited by Savigny Dd, Adam T. Geneva: World Health Organization. 2009.https://iris.who.int/handle/10665/44204 - Nies H, Stekelenburg D, Minkman M, Huijsman R. A decade of lessons learned from integration strategies in the Netherlands. International Journal of Integrated Care. 2021;21(S2):
Article 15 . DOI: 10.5334/ijic.5703 - Svensson I, von Knorring M, Hagerman H, Fagerström C, Ekstedt C, Smeds Alenius L. Unfolding alignment – How top management work to align demand and capacity: an ethnographic study of resilience in a Swedish healthcare region. BMC Health Services Research. 2023;23(321). DOI: 10.1186/s12913-023-09291-0
- Kanter RM. Men and Women of the Corporation. Basic Books; 1993.
- Hagerman H, Skytt B, Wadensten B, Högberg H, Engström M. A longitudinal study of working life among first-line managers in the care of older adults. Applied Nursing Research. 2016;32:7–13. DOI: 10.1016/j.apnr.2016.03.003
- Hagerman H, Högberg H, Skytt B, Wadensten B, Engström M. Empowerment and performance of managers and subordinates in elderly care: A longitudinal and multilevel study. Journal of Nursing Management. 2017;25(8):647–56. DOI: 10.1111/jonm.12504
- Iflaifel M, Lim RH, Ryan K, Crowley C. Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience. BMC Health Services Research. 2020;20(1):
324 . DOI: 10.1186/s12913-020-05208-3 - Hasche N, Höglund L, Mårtensson M. Intra-organizational trust in public organizations – the study of interpersonal trust in both vertical and horizontal relationships from a bidirectional perspective. Public Management Review. 2021;23(12):1768–88. 10.1080/14719037.2020.1764081
- Ree E, Ellis LA, Wiig S. Managers’ role in supporting resilience in healthcare: a proposed model of how managers contribute to a healthcare system’s overall resilience. International Journal of Health Goverment. 2021;26(3):266–80. DOI: 10.1108/IJHG-11-2020-0129
- Rosenbruch A, Nohe C, Schwarz I, Hertel G. Leader trusting behaviours: a mixed-method approach on follower’s perceptions and reactions. European Journal of Work and Organizational Psychology. 2023;32(6):798–815. DOI: 10.1080/1359432X.2023.2250087
- Nowell LS, Norris JM, White DE, Moules NJ. Thematic Analysis: Striving to Meet the Trustworthiness Criteria. International Journal of Qualitative Methods. 2017;16(1):1–13. DOI: 10.1177/1609406917733847
DOI: https://doi.org/10.5334/ijic.8916 | Journal eISSN: 1568-4156
Language: English
Submitted on: Jul 18, 2024
Accepted on: Aug 7, 2025
Published on: Aug 19, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
© 2025 Heidi Hagerman, Mirjam Ekstedt, Mia von Knorring, Cecilia Fagerström, Sara Tolf, Lisa Smeds Alenius, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.