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Empowering patients to need less care and do better in Highland Hospital, South Sweden

Learning Points

What has made the project particularly successful is the fact that we have been able to improve care both from the perspectives of the patients and from that of the staff – indeed, all involved have been winners.

Ensuring that this is the case has meant continuous monitoring of how the system is working. Every week, staff meet to plan the schedule for the coming weeks and to sort out any problems identified – this ensures that all staff are involved on a regular, systematic fashion, assuring the process and demonstrating their commitment to the philosophy underpinning it.

Basically what we did was to change the way we delivered healthcare to a model which is consistent with our views on how anyone should behave toward a fellow human being. To avoid “dropping back” to the traditional repressive way of behaving, we had to discuss and agree the basic values we believed in amongst the staff. We also had to discuss with our patients how we wanted to change the “rules of engagement” – although, in practice, this proved to be a minor problem, as it turned out that they were very keen to work with us in this way.

The most important lesson to us, in the end, was that patients do not cause the healthcare system to «overflow», when they are put in charge. On the contrary, patients are rational people, so they don’t seek health care when their needs have been met. Basically, they use the system responsibly to improve their own health, and in so doing they decrease the unnecessary calls on the time of physicians and nurses. Actually, the results seem to be better when the patients are in charge than when we in the healthcare system try to force patients to do what we think they should.


About this case study
Main Contact

Dr. Jörgen Tholstrup
Chief Medical Officer
Highland District County Hospital
Eksjö, Sweden


Dr. Jörgen Tholstrup provided Governance International  with this case study on 30 March 2010. The case study was updated in June 2014.

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