Kiku Pukk Härenstam

About me
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About me

Kiku Pukk Härenstam is an Associate Professor of Medical management and Systems safety in Healthcare at the Karolinska Institute and senior consultant in Pediatric Emergency Medicine at Astrid Lindgrens Childrens Hospital. She is the medical director of the Pediatric Centre for Advanced Medical Simulation and Training at Astrid Lindgrens Childrens Hospital.

Research

My research focuses on patient safety, human factors and resilient healthcare in diverse contexts.

Teaching

Senior instructor Pediatric centre for Advanced Medical Simulation and Training, Astrid Lindgrens Childrens Hospital
Course director and examiner 2LK159 SVK Akutsjukvård -det akut sjuka barnet 2019- ongoing

Articles

Article: ACTA PAEDIATRICA. 2025;114(2):410-416
A retrospective evaluation of SwePEWS use in paediatric patients with COVID-19 and RSV infection
Bodlund J; Wimmerdahl A; Honore A; Harenstam KP; Forsberg D
Article: SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE. 2024;32(1):93
Paediatric mass casualty response through the lens of Functional Resonance Analytical Methodology- lessons learned
Mackinnon RJ; Slater D; Jenner R; Stenfors T; Kennedy C; Harenstam KP
Article: BMJ OPEN. 2024;14(8):e089224
Safety-netting strategies for primary and emergency care: a codesign study with patients, carers and clinicians in Sweden
Wannheden C; Hagman J; Riggare S; Haerenstam KP; Fernholm R
Article: BMC HEALTH SERVICES RESEARCH. 2024;24(1):71
Behavioral sciences applied to acute care teams: a research agenda for the years ahead by a European research network
Keller S; Jelsma JGM; Tschan F; Sevdalis N; Lollgen RM; Creutzfeldt J; Kennedy-Metz LR; Eppich W; Semmer NK; Van Herzeele I; Harenstam KP; de Bruijne MC
Article: HEALTH COMMUNICATION. 2023;38(14):3102-3112
Now What? Collective Sensemaking and Sensegiving in the Cystic Fibrosis Community in Sweden During the Initial Phase of the COVID-19 Pandemic
Wannheden C; Hasson H; Hager A; Karlgren K; Harenstam KP
Article: ERGONOMICS. 2023;66(12):2106-2120
Exploring patient flow management through a lens of cognitive systems engineering
Hybinette K; Praetorius G; Ekstedt M; Pukk Haerenstam K
Article: BMJ OPEN. 2023;13(10):e077938
Patients' and clinicians' views on the appropriate use of safety-netting advice in consultations-an interview study from Sweden
Fernholm R; Wannheden C; Lycke ST; Riggare S; Harenstam KP
Article: LAKARTIDNINGEN. 2023;120:23047
[Psychological safety for health care staff: What? Why? How?].
Savage C; Savage M; Mazzocato P; Pukk Härenstam K
Article: ACTA PAEDIATRICA. 2023;112(8):1670-1682
Identifying neonatal adverse events in preterm and term infants using a paediatric trigger tool
Dillner P; Unbeck M; Norman M; Nydert P; Harenstam KP; Lindemalm S; Wackernagel D; Forberg U
Article: BMC HEALTH SERVICES RESEARCH. 2023;23(1):651
Exploring everyday work as a dynamic non-event and adaptations to manage safety in intraoperative anaesthesia care: an interview study
Olin K; Klinga C; Ekstedt M; Pukk-Harenstam K
Article: BMC EMERGENCY MEDICINE. 2023;23(1):65
Decision-making on the fly: a qualitative study of physicians in out-of-hospital emergency medical services
Karmelic E; Lindlof H; Luckhaus JL; Castillo MM; Vicente V; Harenstam KP; Savage C
Article: LAKARTIDNINGEN. 2023;120:22125
[Choosing Wisely in Sweden].
Almquist M; Pétursson H; Hultberg J; Holm H; Axelsson M; Cizinsky S; Pukk Härenstam K; Bergh C; Serrander M
Article: LAKARTIDNINGEN. 2022;119:22062
Triage – begränsar syftet nyttan?
Pukk Härenstam K; Djärv T
Article: BMC HEALTH SERVICES RESEARCH. 2022;22(1):662
Improving care for immigrant women before, during, and after childbirth - what can we learn from regional interventions within a national program in Sweden?
Nystrom ME; Larsson EC; Pukk Harenstam K; Tolf S
Article: BRITISH JOURNAL OF ANAESTHESIA. 2022;128(2):e120-e126
Adaptations to practice and resilience in a paediatric major trauma centre during a mass casualty incident
MacKinnon RJ; Slater D; Pukk-Harenstam K; Schwarz UVT; Stenfors T
Article: BMJ OPEN. 2022;12(1):e052283
Mapping registered nurse anaesthetists' intraoperative work: tasks, multitasking, interruptions and their causes, and interactions: a prospective observational study
Olin K; Goras C; Nilsson U; Unbeck M; Ehrenberg A; Pukk-Harenstam K; Ekstedt M
Article: ADVANCES IN SIMULATION. 2021;6(1):21
A novel approach to explore Safety-I and Safety-II perspectives in in situ simulations-the structured what if functional resonance analysis methodology
Mackinnon RJ; Pukk-Harenstam K; Kennedy C; Hollnagel E; Slater D
Article: BMC HEALTH SERVICES RESEARCH. 2021;21(1):480
The work of having a chronic condition: development and psychometric evaluation of the distribution of co-care activities (DoCCA) scale
Schwarz UVT; Roczniewska M; Harenstam KP; Karlgren K; Hasson H; Menczel S; Wannheden C
Article: BMJ OPEN. 2021;11(3):e040358
A First-line management team's strategies for sustaining resilience in a specialised intensive care unit-a qualitative observational study
Hybinette K; Harenstam KP; Ekstedt M
Article: JMIR SERIOUS GAMES. 2021;9(1):e21988
Game Experience and Learning Effects of a Scoring-Based Mechanic for Logistical Aspects of Pediatric Emergency Medicine: Development and Feasibility Study
Zhang C; Hauge JB; Harenstam KP; Meijer S
Article: BMC HEALTH SERVICES RESEARCH. 2021;21(1):48
Acting between guidelines and reality- an interview study exploring the strategies of first line managers in patient safety work
Hedskold M; Sachs MA; Rosander T; von Knorring M; Harenstam KP
Article: SUSTAINABILITY. 2021;13(9):5221
What's the Name of the Game? The Impact of eHealth on Productive Interactions in Chronic Care Management
Wannheden C; von Thiele Schwarz U; ostenson C-G; Pukk Harenstam K; Stenfors T
Article: SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE. 2020;38(4):381-390
Validation and initial results of surveys exploring perspectives on risks and solutions for diagnostic and medication errors in primary care in Sweden
Fernholm R; Wachtler C; Malm-Willadsen K; Holzmann MJ; Carlsson AC; Nilsson GH; Harenstam KP
Article: DRUG, HEALTHCARE AND PATIENT SAFETY. 2020;12:31-40
` Drug Use and Type of Adverse Drug Events-Identified by a Trigger Tool in Different Units in a Swedish Pediatric Hospital
Nydert P; Unbeck M; Harenstam KP; Norman M; Lindemalm S
Article: BMC FAMILY PRACTICE. 2020;21(1):20
Patient-related factors associated with an increased risk of being a reported case of preventable harm in first-line health care: a case-control study
Fernholm R; Holzmann MJ; Wachtler C; Szulkin R; Carlsson AC; Harenstam KP
Article: SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE. 2020;38(1):66-74
Patient and provider perspectives on reducing risk of harm in primary health care: a qualitative questionnaire study in Sweden
Fernholm R; Holzmann MJ; Malm-Willadsen K; Harenstam KP; Carlsson AC; Nilsson GH; Wachtler C
Article: EUROPEAN JOURNAL OF GENERAL PRACTICE. 2019;25(3):128-135
Diagnostic errors reported in primary healthcare and emergency departments: A retrospective and descriptive cohort study of 4830 reported cases of preventable harm in Sweden
Fernholm R; Harenstam KP; Wachtler C; Nilsson GH; Holzmann MJ; Carlsson AC
Article: BMJ OPEN. 2019;9(5):e026410
Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study
Goras C; Olin K; Unbeck M; Pukk-Harenstam K; Ehrenberg A; Tessma MK; Nilsson U; Ekstedt M
Article: ADVANCES IN SIMULATION. 2019;4:4
Defining and measuring quality in acute paediatric trauma stabilisation: a phenomenographic study.
MacKinnon RJ; Pukk-Härenstam K; Von Thiele Schwarz U; Kennedy C; Stenfors T
Article: LAKARTIDNINGEN. 2018;115:E7UC
[Safe Surgery Saves Lives - 10 years of Swedish experience].
Ahlberg J; Pukk-Härenstam K
Article: ADVANCES IN SIMULATION. 2018;3:15
A systematic literature review of simulation models for non-technical skill training in healthcare logistics.
Zhang C; Zhang C; Grandits T; Härenstam KP; Hauge JB; Meijer S
Article: INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE. 2017;29(6):853-860
Safer paediatric surgical teams: A 5-year evaluation of crew resource management implementation and outcomes
Savage C; Gaffney FA; Hussain-Alkhateeb L; Ackheim PO; Henricson G; Antoniadou I; Hedskold M; Harenstam KP
Article: LAKARTIDNINGEN. 2017;114:ELXX
[Patient involvement in patient safety].
Andreen Sachs M; Pukk Härenstam K
Article: LAKARTIDNINGEN. 2016;112:DFEC
[Cognitive and social skills are necessary for safe teamwork].
Pukk Härenstam K; Gaffney D
Article: LAKARTIDNINGEN. 2016;113:D7CP
Teamarbete präglar sjukvården allt mer - Att kommunicera och arbeta i team kräver övning - utmaning omvandla träning till klinisk vardag.
Lindgren P; Pukk Härenstam K
Article: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. 2016;95(5):596-603
Results from the National Perinatal Patient Safety Program in Sweden: the challenge of evaluation
Luthander CM; Kallen K; Nystrom ME; Hogberg U; Hakansson S; Harenstam KP; Grunewald C
Article: LAKARTIDNINGEN. 2015;112:DHMM
[Safer Swedish healthcare requires coherent and persistent efforts].
Gustafson P; Ahlberg J; Ekstedt M; Lindh M; Pukk Härenstam K; Rutberg H
Article: LAKARTIDNINGEN. 2015;112:DFEC
[Cognitive and social skills are necessary for safe teamwork].
Pukk Härenstam K; Gaffney D
Article: BMC HEALTH SERVICES RESEARCH. 2014;14:655
Validation of triggers and development of a pediatric trigger tool to identify adverse events
Unbeck M; Lindemalm S; Nydert P; Ygge B-M; Nylen U; Berglund C; Harenstam KP
Article: BMC HEALTH SERVICES RESEARCH. 2013;13:332
Psychometric properties of the hospital survey on patient safety culture, HSOPSC, applied on a large Swedish health care sample
Hedskold M; Pukk-Harenstam K; Berg E; Lindh M; Soop M; Ovretveit J; Sachs MA
Article: PATIENT SAFETY IN SURGERY. 2013;7(1):10
Is detection of adverse events affected by record review methodology? an evaluation of the "Harvard Medical Practice Study" method and the "Global Trigger Tool"
Unbeck M; Schildmeijer K; Henriksson P; Jurgensen U; Muren O; Nilsson L; Harenstam KP
Article: INTERNATIONAL JOURNAL OF NURSING STUDIES. 2013;50(4):527-535
Design, application and impact of quality improvement 'theme months' in orthopaedic nursing: A mixed method case study on pressure ulcer prevention
Unbeck M; Sterner E; Elg M; Fossum B; Thor J; Harenstam KP
Article: SCANDINAVIAN JOURNAL OF CARING SCIENCES. 2010;24(4):671-677
Healthcare processes must be improved to reduce the occurrence of orthopaedic adverse events
Unbeck M; Dalen N; Muren O; Lillkrona U; Harenstam KP
Article: LAKARTIDNINGEN. 2010;107(10):685-689
[Efficient training in cooperation within your own emergency department. With patient simulation and skilled trainers].
Westfelt P; Hedsköld M; Pukk-Härenstam K; Svensson R-M; Wallin C-J
Article: INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE. 2009;22(2):168-182
Patient safety as perceived by Swedish leaders
Harenstam KP; Elg M; Svensson C; Brommels M; Ovretveit J
Article: QUALITY AND SAFETY IN HEALTH CARE. 2008;17(4):259-263
Analysis of 23 364 patient-generated, physician-reviewed malpractice claims from a non-tort, blame-free, national patient insurance system:: lessons learned from Sweden
Pukk-Harenstam K; Ask J; Brommels M; Thor J; Penaloza RV; Gaffney FA
Article: LAKARTIDNINGEN. 2008;105(20):1457-1458
[Proposal on new internship training doesn't fulfill international requirements].
Savage C; Härenstam KP
Journal article: LAKARTIDNINGEN. 2006;103(1-2):62
[Health care a high-risk industry--information now better than new studies].
Pukk K
Article: INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE. 2005;17(4):363-367
The DNA damage response and patient safety: engaging our molecular biology-oriented colleagues
Pukk K; Aron DC
Article: QUALITY MANAGEMENT IN HEALTH CARE. 2003;12(4):232-239
Do health care managers know the comparative quality of their care?
Pukk K; Lundberg J; Gaffney A; Penaloza-Pesantes RV; Olsson J
Article: QUALITY MANAGEMENT IN HEALTH CARE. 2003;12(4):225-231
Do women simply complain more? National patient injury claims data show gender and age differences.
Pukk K; Lundberg J; Penaloza-Pesantes RV; Brommels M; Gaffney FA
Article: QUALITY MANAGEMENT IN HEALTH CARE. 2002;10(4):38-40
A letter from Sweden: reflections from an industrial espionage assignment in academia.
Lindberger J; Pukk K
Article: EUROPEAN JOURNAL OF PHARMACOLOGY. 1998;349(2-3):325-331
Effects of 3-mercaptopicolinic acid and a derivative of chlorogenic acid (S-3483) on hepatic and islet glucose-6-phosphatase activity
Khan A; Ling ZC; Pukk K; Herling AW; Landau BR; Efendic S
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All other publications

Preprint: RESEARCH SQUARE. 2024
A Functional Resonance Analytical Methodology exploration of the essential functions of a paediatric major trauma centre responding to a mass casualty incident
MacKinnon RJ; Slater D; Jenner R; Stenfors T; Kennedy C; Pukk-Harenstam K
Preprint: RESEARCH SQUARE. 2021
Acting between guidelines and reality. Managers’ balancing between standardisation and adaptive behaviour in patient safety work- an interview study
Hedsköld M; Sachs MA; Rosander T; von Knorring M; Harenstam KP
Book chapter: SIMULATION GAMING THROUGH TIMES AND DISCIPLINES: LECTURE NOTES IN COMPUTER SCIENCE. 2021;p. 35-49
Structuring Game Design with Active Learning Benefits: Insights from Logistical Skills Training in Managing an Emergency Department
Zhang C; Härenstam KP; Nordquist J; Meijer S
Preprint: RESEARCH SQUARE. 2020
Acting between checklists and reality. Managers’ balancing between standardization and adaptive behaviour in patient safety work- an interview study
Hedsköld M; Sachs MA; Rosander T; von Knorring M; Harenstam KP
Preprint: RESEARCH SQUARE. 2020
Acting between guidelines and reality. Managers’ balancing between standardisation and adaptive behaviour in patient safety work- an interview study
Hedsköld M; Sachs MA; Rosander T; von Knorring M; Harenstam KP
Preprint: JMIR PREPRINTS. 2020
Game Experience and Learning Effects of a Scoring-Based Mechanic for Logistical Aspects of Pediatric Emergency Medicine: Development and Feasibility Study (Preprint)
Zhang C; Baalsrud Hauge J; Härenstam KP; Meijer S
Preprint: RESEARCH SQUARE. 2020
Acting between Checklists and Reality. Managers’ Balancing between Standardization and Adaptive Behaviour in Patient Safety Work- an Interview Study
Hedsköld M; Sachs MA; Rosander T; von Knorring M; Harenstam KP
Corrigendum: ADVANCES IN SIMULATION. 2019;4:7
Correction to: A systematic literature review of simulation models for non-technical skill training in healthcare logistics.
Zhang C; Grandits T; Härenstam KP; Hauge JB; Meijer S
Book chapter: GAMES AND LEARNING ALLIANCE: LECTURE NOTES IN COMPUTER SCIENCE. 2019;p. 468-478
A Serious Logistical Game of Paediatric Emergency Medicine: Proposed Scoring Mechanism and Pilot Test
Zhang C; Baalsrud Hauge J; Härenstam KP; Meijer S
Editorial comment: INTERNATIONAL JOURNAL OF NURSING STUDIES. 2015;52(1):484-485
Choose your tool wisely: U charts are more informative than run charts with or without tests of significance. A comment on Unbeck et al. (2014), Unbeck et al. (2013) and Kottner (2014) Response
Unbeck M; Sterner E; Elg M; Fossum B; Thor J; PukkHarenstam K
Editorial comment: INTERNATIONAL JOURNAL OF NURSING STUDIES. 2014;51(2):348-349
The value of Statistical Process Control in quality improvement contexts: Commentary on Unbeck et al. (2013) Response
Unbeck M; Sterner E; Elg M; Fossum B; Thor J; Harenstam KP
Review: BMC HEALTH SERVICES RESEARCH. 2013;13:282
Retrospective record review in proactive patient safety work - identification of no-harm incidents
Schildmeijer K; Unbeck M; Muren O; Perk J; Harenstam KP; Nilsson L
Other: POSTGRADUATE MEDICAL JOURNAL. 2009;85(1000):69-73
Analysis of 23 364 patient-generated, physician-reviewed malpractice claims from a non-tort, blame-free, national patient insurance system: lessons learned from Sweden (Reprinted from Quality & Safety in Health Care, vol 17, pg 259-63, 2008)
Pukk-Harenstam K; Ask J; Brommels M; Thor J; Penaloza RV; Gaffney FA
Review: QUALITY AND SAFETY IN HEALTH CARE. 2007;16(5):387-399
Application of statistical process control in healthcare improvement:: systematic review
Thor J; Lundberg J; Ask J; Olsson J; Carli C; Haerenstam KP; Brommels M
Doctoral thesis: 2007
Learning from patient injury claims
Härenstam KP

Grants

APOLLO28-Improving Mental Health, Wellbeing, and Resilience of Healthcare Workers in Changing Environments
Apollo 2028 – EU Horizon Europe Grant
1 January 2024
LST-STRATEGY – Strategies for large system transformations in a decentralized healthcare system
Forte - the Swedish Research Council for health, Working Life and Welfare
1 January 2019 - 31 December 2022
FK Hälsa - National initiative for delivery care and womens health - national, regional and local strategies for supporting and achieving change
Swedish Ministry of Health and Social Affairs - via Swedish Association of Local Authorities and Regions
1 May 2017 - 31 December 2025

Employments

Affiliated to Teaching/Tutoring, Department of Women's and Children's Health, Karolinska Institutet, 2024-2027
Affiliated to Research, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 2023-2026

Degrees and Education

Docent, Karolinska Institutet, 2020
Doctor Of Philosophy, Department of Learning, informatics, Management and Ethics, Karolinska Institutet, 2007
University Medical Degree, Karolinska Institutet, 2002

About me

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