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Objectives. To assess the effects of network development between primary and special health care units on attitudes towards work and well-being at work among health care staff. Study design. A prospective quasi-experimental design with intervention (n=33) and control (n=23) groups. This 2-year pilot intervention study was implemented in 14 health centres and 4 hospitals in northern Finland. Methods. The material was gathered via self-reported questionnaires from the health care staff at baseline and 1 follow-up. The intervention was composed of regional networking, self-ruling teamwork, staff education and guidance for the multiprofessional teams consisting of participants from primary and special health care units. The objective of these teams was to construct and disseminate regional models of patient education for the service process of 6 patient groups: cardiovascular, COPD, total joint replacement, cerebral infarction, cancer and chronic ulcer patients. Results. The network development intervention had positive effects on attitudes towards work concerning organizational commitment, occupational commitment and growth satisfaction. The positive effects were also found in well-being at work, measured by absorption. The results are encouraging, although the study failed to demonstrate statistically significant improvements in other attitude and well-being outcomes that were measured. Conclusions. Network development intervention particularly improved positive attitudes towards work among health care staff. Although randomized controlled trials are needed, regional network development between health centres and hospitals is recommended when the goal is positive attitudes towards work and well-being at work in sparsely populated and rural areas.

Evaluating care pathways, strengthening patient education, developing staff's patient education skills, and improving collaboration between primary and special healthcare workers are all topical challenges. Successful patient education requires seamless cooperation across organizational boundaries throughout the whole nursing process. The aim of this study is to describe participants' experiences of development work between primary and special health care units on patient education. In this qualitative descriptive study twenty four health care workers who took part in development work in a collaborative project of special and primary health care service in northern Finland were interviewed when they had nine months' experience of the development work. The material was analysed using content analysis. Experiences of the nature of development work were described using the following categories: attachment to development work, delight in participation, factors supporting success and challenges of development work. Improvement of co-operation between special and primary health service is a topical challenge. Participation in development work offers occupational learning opportunities. Evaluation and development of own work strengthens staff members' occupational know-how. The results of this research may be utilized in the planning and execution of development work in the field of health care.[9] Kouri, P., Karjalainen-Jurvelin, R. and Kinnunen J. (2005) Commitment of project participants to developing health care services based on the Internet technology.

Objective: Evaluating care pathways, strengthening patient education, developing staff's patient education skills, and improving collaboration between healthcare workers in hospitals and health centers are all topical challenges in the field of healthcare. Successful patient education requires seamless co-operation across organizational boundaries throughout the whole nursing process. The aim of this study was to assess personnel's experiences of a developmental nursing project, involving networking between Finnish primary (health centers) and special (hospitals) healthcare organizations, and the significance of development work on patient education in terms of strengthening information flow, co-operation and know-how. The aim of the study was to explore the healthcare personnel's experiences of development work in the context of networking between organizations, specifically focusing on the impact of development work with regard to information flow, co-operation and strengthening know-how. The specific research question was addressed: What is the impact of development work in this context in relation to information flow, co-operation and readiness for patient education?Methods: Data were collected from theme interviews (n=24) with primary and special healthcare team members who participated in a collaborative project, then analyzed by qualitative content analysis. Results:The findings indicate that development work on patient education improves collective expertise, key components of which are learning as a patients' counselor, collective know-how, and the exchange of knowledge.Conclusions: Development work can strengthen individual and collective know-how and nursing expertise. In the examined project, enhanced network co-operation increased collaboration between organizations and improved information flow throughout the nursing process. In addition, promotion of development on nursing and provision of feedback to the participants by the nurse manager appear to be crucial for successful development work on patient education. Workplaces and the nurse managers need to provide adequate resources' to develop nursing processes as well as motivate employees to improve nursing. Additionally, nurse managers should support and guide the healthcare workers in development work toward this goal. Well planned and executed development project can improve nursing practices across organizational boundaries.