Gunilla Avby has a Master of Arts with a major in Education and a Bachelor in Human ResourceDevelopment. She has extended working experience from the adult learning area, especially with a focus on executive training in the public sector. Her research interest lays in workplace learning and she is currently doing Ph.D. research into knowledge use among social workers. Per Nilsen is an associate professor of Community Medicine. His research has focused on health care interventions aimed at achieving health-related behaviour change and he has a particular interest in behaviour change mechanisms. Madeleine Abrandt-Dahlgren is professor in Medical Education. Her main research interest concerns student learning in higher education with a particular view to professional learning in different fields, as well as the relationship between higher education and working life.Corresponding author's contact details: Gunilla Avby, Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden. E-mail: gunilla.avby@liu.se AcknowledgementNo funding has been received for this study.Ways of understanding evidence-based practice in social work: a qualitative study AbstractThis qualitative, empirical study explores and describes the variation in how evidencebased practice (EBP) is understood in social work. A phenomenographic approach to design and analysis was applied. Fourteen semi-structured interviews were conducted with politicians, managers and executive staff in three social welfare offices in Sweden.The main findings suggest that there are qualitatively different ways in which EBP is understood, described in five categories: (i) fragmented; (ii) discursive; (iii) instrumental; (iv) multifaceted; and (v) critical. The outcome space is hierarchically structured with a logical relationship between the categories. However, the informants found it difficult to account for EBP, depending on what was expressed as deficient knowledge of EBP in the organization, as well as ability to provide a seemly context for EBP. The results highlight the importance of acknowledging these differences in the organization to compose a supportive atmosphere for EBP to thrive rather than merely assume the case of evidence-based social work. The categories can be utilized as stimuli for reflection in social work practice, and thereby provide the possibility to promote knowledge use and learning in the evolving evidence-based social work.

Purpose The purpose of this paper is to explore work motivation among professionals at well-functioning primary healthcare centers subject to a national healthcare reform which include financial incentives. Design/methodology/approach Five primary healthcare centers in Sweden were purposively selected for being well-operated and representing public/private and small/large units. In total, 43 interviews were completed with different medical professions and qualitative deductive content analysis was conducted. Findings Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers' positive management was due to a unique combination of factors, such as clear direction of goals, a culture of non-hierarchical collaboration, and systematic quality improvement work. The financial incentives need to be translated in terms of quality patient care to provide clear direction for the professionals. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created. Practical implications Leaders need to consistently translate and integrate reforms with the professionals' drives and values. This is done by encouraging participation through teamwork, time for structured reflection, and quality improvement work. Social implications The design of the reforms and leadership are essential preconditions for work motivation. Originality/value The study offers a more complete picture of how reforms are managed at primary healthcare centers, as different medical professionals are included. The value also consists of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms.

The aim of this study was to explore knowledge use and learning among social workers in everyday child investigation work. Research was undertaken in two Swedish children's services departments. The study applied an ethnographic approach. Methods for data collection included interviews, participant observations, reflective dialogues and a documentary analysis of case files. The social workers' knowledge sources were classified into research‐based, practice‐based and ordinary knowledge. The findings show that the social workers preferred practice‐based knowledge, which was primarily conveyed from colleagues and previous experience, and rarely consulted knowledge from sources found outside the practice setting. Furthermore, the findings suggest that the integration of knowledge was made possible through the social workers' engagement in both a verbal and a more cognitive (tacit) reasoning activity, processes that fostered learning at work. The social workers' learning was predominantly adaptive as they learned to handle tasks in a fairly routinized way on the basis of rules or procedures. The findings lend support to the notion that the use of different knowledge forms could potentially trigger learning in everyday social work.

Objective: Staff experiences of healthy work environment (HWE) indicators at primary care units can assist in understanding why some primary care units function better than others. The aim of the study was to create increased understanding of how workers experienced HWE indicators at well-functioning primary care units. Design: Fifty in-depth interviews with staff at six primary care units in Sweden were analysed with deductive content analysis, revisiting a systematic review of HWE indicators. Results: The study presents additional perspectives on staff experiences of HWE indicators at well-functioning primary care units. The included primary care units (PCU) shared a similar pattern of work environment indicators, with unique solutions and strategies to meet shared challenges. Staff at the included PCUs were encouraged to work to create and sustain a HWE, but each domain (indicator) also provided challenges that the staff and organisation needed to meet. The results suggest that useful approaches for a healthy work environment could be to address issues of organisational virtuousness, employee commitment and joy at work. Conclusions: Both managers and staff are encouraged to actively work not only to create and sustain an HWE but also to promote organisational virtuousness, employee commitment, joy at work and to increase the performance at work, which is of benefit to staff, patients and society. Key Points Staff at well-functioning primary care units (PCUs) experienced healthy work environments The included PCUs shared a similar pattern of work environment indicators, with unique solutions and strategies to meet shared challenges. Staff at the included PCUs were encouraged to work to create and sustain a healthy work environment, but each domain (indicator) also provided challenges that the staff and organisation needed to meet. The results suggest that useful approaches for a healthy work environment could be to address issues of organisational virtuousness, employee commitment and joy at work.

BackgroundPolicymakers in many countries are involved in system reforms that aim to strengthen the primary care sector. Sweden is no exception. Evidence suggests that targeted financial micro-incentives can stimulate change in certain areas of care, but they do not result in more radical change, such as innovation. The study was performed in relation to the introduction of a national health care reform, and conducted in Jönköping County Council, as the region’s handling of health care reforms has attracted significant national and international interest. This study employed success case method to explore what enables primary care innovations.MethodsFive Primary Health Care Centres (PHCCs) were purposively selected to ensure inclusion of a variety of aspects, such as size, location, ownership and regional success criteria. 48 in-depth interviews with managers and staff at the recruited PHCCs were analysed using content analyses. The COREQ checklist for qualitative studies was used to assure quality standards.ResultsThis study identified three types of innovations, which break with previous ways of organizing work at these PHCCs: (1) service innovation; (2) process innovation; and (3) organizational innovation. A learning-oriented culture and climate, comprising entrepreneurial leadership, cross-boundary collaboration, visible and understandable performance measurements and ability to adapt to external pressure were shown to be advantageous for innovativeness.ConclusionsThis qualitative study highlights critical features in practice that support primary care innovation. Managers need to consistently transform and integrate a policy “push” with professionals’ understanding and values to better support primary care innovation. Ultimately, the key to innovation is the professionals’ engagement in the work, that is, their willingness, capability and opportunity to innovate.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-3874-y) contains supplementary material, which is available to authorized users.