A Study of Coordination in a Swedish Health Care Setting - Approaching obstacles and success factors through Lean and Relational Coordination

Abstract: In public health care, organisation and coordination are frequent areas of debate. Health care has also been subject to many reforms and investigations, without arriving at a satisfying solution for how to organise and coordinate in an optimal way. This thesis aims to look closer at the concept samverkan within Swedish health care and more specifically, identify obstacles and how to solve them, as well as identifying success factors. To do this, we have conducted an empirical study wherein we interview caregivers in psychiatry and geriatry in the Sörmland county, to get their views on and experience of samverkan. Through our empirical study, we identified several obstacles, including suboptimal use of IT systems and clinics organised as isolated units, as well as success factors such as good working relationships and established routines of inter-disciplinary meetings. With these results, we conducted an analysis based on two main theories of organisation and coordination, Lean and Relational Coordination. These theories were helpful in determining possible solutions to the obstacles, and could also help explain success factors. To conclude, we have drafted a decision matrix for pinpointing when it would be suitable to use the respective organisational theories. However, the main takeaway is that difficulties will arise if one tries to organise according to one theory only. Solutions should be tailored to the needs of the different parts of the care process.