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The Esther approach to healthcare in Sweden: A business case for radical improvement

Costs and Savings

There is no special budget for the Esther organisation within any of the clinical departments. Only one person is  paid as a co-ordinator - all others involved in Esther accommodate this as part of their normal work.

It is the continuous improvement work by staff at the frontline who create the results. Esther also involves patients in improvement work and they get some flowers or other compensation ‘in kind’ but no other form of compensation.

The budget is a problem, Esther gets some funding now and then but meetings and improvement work has to be a natural part of the daily work.

The 2011 budget for Esther was 1.8 million kr (£170,741) including salary of the coordinator, coach education and new improvement projects. In 2012 the budget was reduced to 1.6 million kr (£151,705). In 2013 there will be a very small budget for Esther, forecast to be 800,000 kr (£75,852), which is meant to pay for 100% of the coordinator’s time and to provide 40,000 kr (£3,800) to do activities (which is unlikely to be enough to continue activities at their former level).


About this case study
Main Contact

Nicoline Vackerberg
Director of the Esther Network


Nicoline Vackerberg wrote this case study for Governance International in January 2013.

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