Birgithe Eckermann Sandbæk

• Helgheim, Berit & Sandbæk, Birgithe Eckermann (2021). Who is doing what in home care services? International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(19), p. 1–9. doi: 10.3390/ijerph181910504. Full text in Research Archive Show summary

  Background: This paper investigates the distribution of work hours by activity, for the main staff categories in home care services in three rural Norwegian municipalities. In Norway these categories are registered nurses, assistant nurses and assistant health workers. (2) Methods: The three categories of home care staff recorded 20,964 eligible observations over 8 weeks. We identified 19 activities, which were recorded. The majority of staff used a smartphone application for the time measuring, while some staff used a manual form for reporting purposes. (3) Results: The registered nurses (RNs) spent 32% of their time on direct patient work, while driving accounted for 18%. Direct patient work and driving accounted for the majority of activities performed by assistant nurses (48% and 29%, respectively) and assistant health workers (70% and 17%, respectively). (4) Conclusions: The demand for home care services is increasing in terms of both size and complexity. Simultaneously, there is a growing shortage of skilled staff. RNs is the group with the least face-toface time with patients. To meet the patients’ needs, it is necessary to discuss and modify existing home care service systems in order to use resources appropriately and effectively. Keywords: home care, staffing, health care organizations and systems

• Helgheim, Berit; Sandbæk, Birgithe Eckermann & Slyngstad, Line (2018). A prospective investigation of direct and indirect home care activities in three rural Norwegian municipalities. BMC Health Services Research. 18(1). doi: 10.1186/s12913-018-3794-2. Full text in Research Archive Show summary

  Background: Home care providers struggle to manage their day-to-day work, which is increasing in volume and complexity. In general, they are expected to achieve more with the same planning methods, resources, and capacity. To meet emerging needs and use the available resources more effectively and efficiently, evidence and strategies are needed to inform planning methods for home care services. However, limited data are available to inform this change. This paper investigated the amount of time used to carry out direct activities and six indirect activities across three rural Norwegian municipalities (M1, M2 and M3). Methods: Home care staff recorded data over 8 weeks in 2016; the majority of the staff used a smartphone application and some staff used a manual form to report the durations of the activities. Results: The median time spent on direct activities was 11–13 min, and this work constituted less than 50% of the total work in the three municipalities. The median driving time was 5–7 min, which accounted for 43–54% of the total indirect work. Administration, particularly reporting and documentation, displayed greater differences across the municipalities, together accounting for 38–50% of the total indirect time. M2 and M3 used substantially more time for documentation, including 20 min in M2 and M3, in contrast to only 1 min in M1. Similarly, the median reporting times were 30 min (M2) and 28 min (M3), compared with only 17 min in M1. Conclusions: Home care staff spent less time on direct activities than on indirect activities, of which several activities have the potential for change. These results may help managers utilize resources effectively and plan appropriately, and they may also serve as a basis for future research to identify areas with improvement opportunities and, in turn, make more time available for direct patient care. Keywords: prospective study, activity data, rural home care services, direct and indirect home care, process investigation

• Sandbæk, Birgithe Eckermann; Helgheim, Berit Irene; Larsen, Odd I & Fasting, Sigurd (2014). Impact of changed management policies on operating room efficiency. BMC Health Services Research. 14(224), p. 1–10. doi: 10.1186/1472-6963-14-224. Full text in Research Archive Show summary

  Background: To increase operating room (OR) efficiency, a new resource allocation strategy, a new policy for patient urgency classification, and a new system for OR booking was implemented at a tertiary referral hospital. We investigated the impact of these interventions. Methods: We carried out a before-and-after study using OR data. A total of 23 515 elective (planned) and non-elective (unplanned) orthopaedic and general surgeries were conducted during calendar year 2007 (period 1) and July 2008 to July 2009 (period 2). The Wilcoxon–Mann–Whitney test was used to calculate statistical significance. Results: An increased amount of case time (7.1%, p < 0.05) was conducted without any increase in out-of-hours case time. Despite having three fewer ORs for electives, slightly more elective case time was handled with 26% less use of overtime (p < 0.05). Mean OR utilization was 56% for the 17 mixed ORs, 60% for the 14 elective ORs, and 62% for the 3 dedicated ORs. A 20% growth (p < 0.05) of non-elective case time was primarily absorbed through enhanced daytime surgery, which increased over 48% (p < 0.05). As a result, the proportions of case time on evenings and nights decreased. Specifically, case time at night decreased by 26% (p < 0.05), and the number of nights without surgery increased from 55 to 112 (out of 315 and 316, respectively). Median waiting time for the middle urgencies increased with 1.2 hours, but over 90% received treatment within maximum acceptable waiting time (MAWT) in both periods. Median waiting time for the lowest urgencies was reduced with 12 hours, and the proportion of cases treated within MAWT increased from 70% to 89%. The proportion of high urgency patients (as a proportion of the total) was reduced from 20% to 12%. Consequently, almost 90% of the operations could be planned at least 24 hours in advance. Conclusions: The redesign facilitated effective daytime surgery and a more selective use of the ORs for high urgency patients out of hours. The synergistic effect probably exceeded the sum of the individual effects of the changes, because the effects of each intervention facilitated the successful implementation of others.

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• Aravazhi, Agaraoli; Helgheim, Berit & Sandbæk, Birgithe Eckermann (2019). Identifying KPI’s by using text mining of administrative board documents in Norwegian hospitals. Full text in Research Archive Show summary

  This paper analyses 36,000 documents by using text mining from board meetings in hospitals in Norway in the period 2008-2017. The purpose is to explore which subjects are emphasized and identify changes in strategic focus during the time span.

• Helgheim, Berit; Sandbæk, Birgithe Eckermann & Slyngstad, Line (2017). Identifying cost drivers in homecare services : a case study of three rural municipalities. Full text in Research Archive
• Sandbæk, Birgithe Eckermann (2011). Healthcare and hospitality. Full text in Research Archive
• Sandbæk, Birgithe Eckermann & Helgheim, Berit Irene (2007). Production models in elderly health care in Norway. Full text in Research Archive Show summary

  In Norway the health care is public financed and driven. However, elderly people are served by local communities and hospitals by region public corporations. This two level system split the responsibilities for production of services for elderly people and the nursing homes tend to send the patients for hospitalizations. Considering the fact that nursing homes already have physicians as well as nurses, the question one might ask is whether this is the most cost efficient way of treating these patients. Further, researchers claim treatment in hospitals may not improve the outcome of various diseases, it may actually be better if they are treated at the nursing homes. In this paper we do a descriptive study of elderly patients in hospitals in order to develop alternative production models of health care services to elderly people.

• Sandbæk, Birgithe Eckermann & Helgheim, Berit Irene (2016). Essays on factors influencing operating room efficiency. Høgskolen i Molde - Vitenskapelig høgskole i logistikk. ISSN 9788279622109. Full text in Research Archive
• Sandbæk, Birgithe Eckermann (2008). Nyttebegrep og prioriteringsspørsmål i norsk helsevesen : et historisk/vitenskapsteoretisk og samtidsperspektiv. Høgskolen i Molde. ISSN 9788279621089. Full text in Research Archive Show summary

  Den økende diskrepansen mellom samfunnets behov for helsetjenester og tilgjengelige ressurser har aktualisert mange prinsipielle spørsmål som knytter seg til prioriteringer. Spørsmål om hvordan man sikrer en rettferdig og legitim fordeling av helsetjenester har derfor blitt viet stor internasjonal oppmerksomhet de senere år. Idet forskjellige prioriteringsprinsipper vil medføre ulik prioritering, er begrepet ¿nytte¿ helt sentralt i denne sammenhengen. Dersom man ønsker en vurdering og sammenlikning av endret nytte, er det viktig å avklare hvilke nyttebegrep og verdier som ligger til grunn for de ulike syn, samt hvilke konsekvenser dette kan medføre. Dette paper beskriver dannelse og fremvekst av ulike etiske teorier sett i en samfunnshistorisk sammenheng. Med utgangspunkt i dilemmaer knyttet til prioriteringer foretatt på et operativt nivå og med henholdsvis en nytte- versus en pliktetisk innfallsvinkel, belyses deretter noen av de konsekvenser dette kan medføre. Når det i dag ikke foreligger verken konsensus eller konkrete retningslinjer for prioritering, kan nettopp det være et uttrykk for at ingen hittil har lykkes i å utforme dette. Spesielt med tanke på de demografiske prognoser, haster det å fullføre dette arbeidet. En utsettelse er også en prioritering.

• Sandbæk, Birgithe Eckermann (2008). The establishment and development of the main theoretical frameworks and research problems related to production planning 1776-1955. Høgskolen i Molde. ISSN 9788279621096. Full text in Research Archive Show summary

  The objective of this paper is to offer a review of some of the main features that contributed to the formation of modern production planning. Primary emphasis is on the time period between 1776 and 1955. In the first part, the paper will outline historical milestones between 1776 and 1910 and in particular examine the impact of some of the pioneers, mainly represented by American contributors. In the latter part, the focus is on the Auto industries and the early development in the 1900s U.S and in the 1950s Japan. Finally, the paper briefly summarises the development in industry and society and the resulting challenges in production planning, stretching from 1980 and towards present time.

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