ABSTRACT
Breakthrough Collaborative (BC) aims at learning through networking, mainly at micro level, and is used as a tool to improve care and welfare organizations. The aim of this study was to explore and illuminate the challenges when applying BC model at meso and macro level. In 2010, the Swedish Health and Medical Services Act stated the responsibility of healthcare professionals to consider children’s needs as relatives. This study uses an interactive collaborative research model. To support healthcare organizations in the implementation of the regulation, county councils/regions in Sweden were invited to take part in a BC during 2015. Six teams from different county councils/regions participated. Team members were interviewed several times during the project time. Data were analyzed with an explorative and descriptive qualitative content analysis. The result illuminates the challenges faced when applying BC at meso and macro level. Most challenges concern preparation, support structures and system connections. There are similarities with the challenges met at micro level when BC is used at meso and macro level. But it seems even more important to consider how the team is constituted at meso and macro level to make use of the learnings and achieve long-term impact in the home organization.
Acknowledgements
The authors want to thank the participating teams that allowed us to follow their improvement trajectory and shared their challenges and experiences. We will also thank Qulturum Jönköping Region County and the project leaders for letting us take part in this project.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes on contributors
Ann-Christine Andersson, Paediatric Nurse Specialist and PhD in Quality Management, works as senior lecturer and researcher at the Jönköping Academy for Improvement of Health and Welfare. Her research concern all aspects of improvement in the area of Health and Welfare.
Marie Golsäter has a PhD in Nursing Science and is working as a Senior Lecturer at the Department of Nursing, CHILD Research group, School of Health and Welfare, Jönköping University and at Futurum, Academy for Health and Care Region Jönköping County.
Boel Andersson Gäre, specialist in paediatrics, is director of the Department of Clinical Research and Education in Jönköping Region, Sweden and professor at the Jönköping Academy for Improvement of Health and Welfare, Jönköping University. Initially trained in epidemiology and outcomes research, but now leads research and education in Improvement Science.
Anna Melke has a PhD in Public Administration and works as a Researcher at the Department of Research and Development at The Göteborg Region Association of Local Authorities. She also teaches at the University of Gothenburg.