We strive to bridge the medical management know-do gap by researching and developing innovative management practices together with practitioners that generate value for staff and patients.
We recognize the great work that is being done in health care today. That is why our goal is to establish long-term research and educational collaborations with health care providers so that what works can be understood and shared with many. The clinical management research group aims to improve clinical impact by contributing to the knowledge about how we can coordinate, lead, and improve the delivery of health care services so as to achieve better outcomes for patients and create value for staff, individuals and their families.
We employ an action learning approach through which we and our health care partners strive to learn together as we delve into management challenges. We employ a multitude of research methodologies to analyze complex interventions. Our core expertise lies in the use of qualitative research methods. We are also developing expertise in the use of quantitative methods to evaluate the effects of multi-components interventions over time, such as Statistical Process Control Charts and interrupted time-series analysis, as well as methods to calculate the costs of healthcare processes, e.g. Time-Driven Activity-Based Costing.
The research group is co-led by post-doc researchers Carl Savage and Pamela Mazzocato. Carl Savage has a background in medicine and management. His main areas of research expertise include Leadership, Learning, Organizations, Improvement and Innovation as well as a passion for improving patient safety. Pamela Mazzocato has a background in economics and management, specifically public management. Her core competence lies in the field of Quality Improvement and Operations Management..
The members in Clinical Management research team have multiple professional backgrounds from medicine, social science, and economics, in addition to experience working as healthcare professionals or in the non-profit sector, as well as in management and consultancy positions. These diverse backgrounds and experiences provide a dynamic foundation for our research
|Sandra Astnell||Education coordinator|
|Ulrika Bäckman||PhD student|
|Jens Jacob Fredriksson||PhD student|
|Mairi Juriska||PhD student|
|George Keel||PhD student|
|Anthony Larsson||PhD student|
|Taina Mäntyranta||Graduate Student|
|Muhammad Rafiq||Research assistant|
|Marie Höjriis Storkholm||Graduate Student|
|Clara Fischer||Research assistant|
|Johanna Brinne Roos||Associated|
|Göran Örnung|| |
Our Projects and Funders
Our projects are made possible by generous grants from a number of funding bodies as well as in cooperation with our partners who often contribute considerable time and money to develop seed projects together with us and thereby support the projects as they evolve from the idea and need stages into fully-funded research projects. The projects we are engaged in span the range of organizational inquiry, from micro and meso levels to the macro systems level.
|Year||Projects and founders|
|2015-||From burnout to engagement: building young physicians’ leadership capacity. AFA, 2 800 000 SEK. Mairi Jüriska’s PhD project.|
Innovation-driven reimbursement models in primary care. VINNOVA, 2 000 000 SEK
|2015-||Business models in birthing care. Stockholm County Council, 400 000 SEK.|
|2014-||Understanding the value of multidisciplinary person-centered chronic disease management. Outcomes and costs of an integrated care unit for patients with cardiovascular disease, reduced kidney function and diabetes. The project has received multiple grants: KID-funding from the Board of Doctoral Education at Karolinska Institutet.282 000 SEK per year; Vårdalstiftelsen, 2 902 000 SEK; FORTE, 2 830 000 SEK.|
Process innovation in primary care.
|2014-||Innovating inside the box: How contextual constraints can contribute to the innovation of health care processes, partly financed by Aarhus University Hospital. Marie Højriis Storkholm’s PhD project.|
|2014-||An alternative way to lead quality improvement. A project financed through the SALAR project on improving care for the frail elderly. 180 000 SEK.|
|2013-||Disrupting Hospitals: Business model transformation within Academic Medicine. In collaboration with and partly financed by Karolinska University Hospital. Jens Jacob Fredriksson’s PhD project.|
|2012-||Simulation and implementation of a lean-inspired hip-fracture care process. ALF, 900 000 SEK.|
|2012-||Simulation modelling in pediatric emergency care. Ulrika Bäckman’s PhD project.|
|2012-2014.||Evidence-based emergency care. A project in collaboration with and financed by the Stockholm’s Southern Hospital, partly financed by Stockholm South General Hospital|
|2008-2013||More Theory in Psychiatric Residency Training – “METIS-projektet”. IPULS AB. Repeated funding grants from the Swedish Ministry of Health and Social Affairs totalling over 30 million SEK for the national residency training program in psychiatry utilizing the Adaptive Reflection change model developed in Carl’s thesis.|
|2003-2005||Navigating Change in Medical Education. Karin Rosander’s Foundation. 1 year fulltime and 2 years half-time funding for research into how to improve medical education.|
We are also involved as co-investigators in the following projects
|2015-||From improvement island to a holistic approach – facilitating improvement initiatives in healthcare. Principal investigator: Monica Nyström. VINNOVA, 950 000 SEK.|
Lean health. Principal Investigator: Terese Stenfors-Hayes. AFA, 2 000 000 SEK.
|2010-2013||Effects of Teamwork on Efficiency, Patient safety, Patient satisfaction and Personnel work environment (the TEPPP study). Principal investigator: Ulrica von Thiele Schwarz. FAS, 2 404 380 SEK|
|2008-2013||A platform for learning about patient safety: The foundations for a positive spiral. Principle investigator: Karin Pukk Härenstam. Vinnvård, 4 million SEK.|
Some of our current and past partners.
At the Danderyd Hospital we have established a long term research and education collaboration with chief doctor Carl-Göran Ericsson, the Quality Development Office and several clinical departments. We have ongoing research projects with Jonas Spaak at the Heart-Nephrology-Diabetes unit for the research project on multidisciplinary person-centered chronic disease management for patients with cardiovascular disease, reduced kidney function and diabetes. We also collaborate with André Stark, Olof Sköldenberg, and Maria Unbeck at the Orthopedic Department for the lean simulation project. At the Quality Development Office we collaborate with Louise Hagander, Johanna Wahlberg and Karin Lindahl Lundberg.
At Stockholm South General Hospital, we collaborate with the CEO Tomas Movin on a project on Business Model for Academic Medical Centres
Astrid Lindgren’s Children’s Hospital, with Ulrika Bäckman, PhD student, in a project on simulation modelling in pediatric emergency department.
Aarhus University Hospital, with Marie Højriis Storkholm on a project about innovation in the face of paradoxical contextual constraints
Legevisitten AB, we collaborate with Staffan Bjessmo on a project about process innovation in primary care
Karolinska University Hospital with the Strategic Services Development unit on the lean program implementation in the emergency department
Mayo Clinic. Karin Pukk Härenstam and the Systems Safety research group.
Stockholm County Council, with Peter Lundqvist in the project “Innovation-driven reimbursement models for primary care”
The Swedish Association of Local Authorities and Regions (SALAR) with Maj Rom, Michael Bergström, and Anette Nilsson in a project on an alternative approach to leading quality improvement with.
Robert S. Kaplan at Harvard Business School, in the project multidisciplinary person-centered chronic disease management for the development of Time-Driven Activity-Based Costing methods for complex care processes
Isis Amer Wåhlin and Peter Lindgren in the Value Based Healthcare Research Network, in the multidisciplinary person-centered chronic disease management project and the project on business models for birthing care
Terese Stenfors-Hayes at the Evaluation Unit, Henna Hasson and Ulrica von Thiele Schwarz in the PROCOME research group, in the Lean Health and TEPPP projects
Helena Hvitfeldt Forsberg at the MMC/P2I care research group, in the hip-fracture simulation modelling project
Monica Nyström in the SOLIID research network, in the Lean Health and the facilitating learning projects.
Bocconi University, with Federico Lega and Stefano Villa at the Centre for Research on Health and Social Management (CERGAS) and at Master of healthcare management, economics and policy (MIHMEP), with healthcare operations management related projects
Unpacking the key components of a programme to improve the timeliness of hip-fracture care: a mixed-methods case study.
Scand J Trauma Resusc Emerg Med 2015 Nov;23():93
Fredriksson, J.J., D. Ebbevi, and C. Savage, Pseudo-understanding: an analysis of the dilution of value in healthcare. BMJ Qual Saf, 2015. 24(7): p. 451-7.
Mazzocato, P., et al., Complexity complicates lean: lessons from seven emergency services. J Health Organ Manag, 2014. 28(2): p. 266-88.
Wannheden, C., et al., HIV and tuberculosis coinfection: a qualitative study of treatment challenges faced by care providers. Int J Tuberc Lung Dis, 2013. 17(8): p. 1029-35.
Tomson, G. and C. Savage, [The Price of Naïveté]. Lakartidningen, 2013. 110(27-28). Book Review.
Tomson, T., G. Tomson, and C. Savage, The educational system of today and health personnel of tomorrow. Lakartidningen, 2012. 109(32-33): p. 1388-9.
Ovretveit, J., et al., Implementing organisation and management innovations in Swedish healthcare: lessons from a comparison of 12 cases. J Health Organ Manag, 2012. 26(2): p. 237-57.
Mazzocato, P., et al., How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden. BMC Health Serv Res, 2012. 12: p. 28.
Turning the tables: when the student teaches the professional -- a case description of an innovative teaching approach as told by the students.
Nurse Educ Today 2011 Nov;31(8):803-8
Mazzocato, P., H.H. Forsberg, and U. Schwarz, Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work. Scand J Trauma Resusc Emerg Med, 2011. 19: p. 70.
Bergin, E. and C. Savage, Surviving multiple obligations through stimulation, autonomy, and variation. J Health Organ Manag, 2011. 25(4): p. 455-68.
Mazzocato, P., et al., Lean thinking in healthcare: a realist review of the literature. Qual Saf Health Care, 2010. 19(5): p. 376-82.
Does an outcome-based approach to continuing medical education improve physicians' competences in rational prescribing?
Med Teach 2009 Nov;31(11):e500-6
Savage, C. and K.P. Harenstam, [Proposal on new internship training doesn't fulfill international requirements]. Lakartidningen, 2008. 105(20): p. 1457-8.
Esmaily, H.M., et al., Identifying outcome-based indicators and developing a curriculum for a continuing medical education programme on rational prescribing using a modified Delphi process. BMC Med Educ, 2008. 8: p. 33.
Bergman, D., et al., Teaching group dynamics--do we know what we are doing? An approach to evaluation. Med Teach, 2008. 30(1): p. 55-61.