Table 1 Exemplary quotations and the 1st order concepts, 2nd order themes and aggregate dimension identified from data analysis
Aggregate dimension: Process of creating an integrated patient experience | 2nd order themes |
1st order concepts with exemplary quotations and actions | |
GPs interpret situation based on discharge notes - It’s not always as easy as this. Sometimes I need to call and ask them to send (…) an unfinished discharge note so that I can understand what’s been done. | GPs cooperate with hospitals |
GPs exclude other organizations (hospital) to solve problem in local community - There is not much more they can do, there are no more investigations to carry out. So, it is (medical condition) management supervised by me. | GPs cooperate with hospitals |
GPs seldom advise hospitals except for complex and frequently hospitalized patients - Then, I write that if they cannot do anything with it now, I think it will be ok and that he can leave and go home and be called on later for follow-up. | GPs cooperate with hospitals |
GPs decouple in highly specialized and periphery topics - Dialogue is often from them to me. (…) I don’t have much to contribute when hospitalized. Then, responsibility of treatment is transferred to the hospital. | GPs cooperate with hospitals |
GPs lack information and is not able to get complete picture in office-visits - I only see him in the office setting. (…) So, it is obvious that he may have needs that I don’t see, and that doesn’t come up during our conversations. | GPs work for holistic focus |
GPs biased towards taking control of medical matters - I messaged home care nurses, informing them that now we will do it this way, and that they can provide the medicine (…) until it comes from the pharmacy. | GPs work for holistic focus |
GPs establish plan for future direction - They don’t know what to do. So, that is why they contacted me now. We have established a plan now, and then we will have to see if it goes well (…). | GPs create continuity |
GPs and patients in follow-up translate discharge notes to context - We summarize and read what’s been done at the hospital, and they can ask questions if there are any from the patient’s perspective. | GPs create continuity |
GPs act as information hubs - Home care nurses are my extended arm to the patient, and (…) alert me if anything is needed. Thus, it is my responsibility to be a patient coordinator. | GPs create continuity |
GPs cooperate better when they have a professional relationship with home care nurses - For this patient I know the people who provide him services, therefore it is easier to communicate and agree on things. | GPs create continuity |
GPs experience common understanding in closer working relations - (…) I don’t need to use the telephone much in communication with home care nurses as they understand the patient’s complexity and needs. | GPs create continuity |
Aggregate dimension: Process of workflow | 2nd order themes |
1st order concepts with exemplary quotations and actions | |
GPs control and follow-up cooperation (due to limited trust) - Then, I guess I secure my work more (…) and, if highly important, ask them for a response and make a reminder for myself. | GPs build internal coherence |
GPs trust other health care professionals (home care nurses) - Because they see her/him often, they have a greater ability to assess how s/he is doing than me who doesn’t see her/him that often. | GPs build internal coherence |
GPs pleased with ways of working (suits resource use, business model and logistics?) - Yes, because I know what’s going on up there, and if s/he needs help with anything, I may be able to contribute, If I get to know we can find solutions. | Reactive and uniform ways of work |
GPs work in stepwise manner - No, there is no need (for meetings). We talk sometimes (telephone) at the beginning, when things need to be clarified, otherwise everything has been digital. | Reactive and uniform ways of work |
GPs experience deteriorating cooperation when breaching established ways of working - It may be that home care nurses are involved with other GPs who take less responsibility than I do, but I think it’s wrong that I should have an even bigger workload because I try to do a good job. | Reactive and uniform ways of work |
Aggregate dimension: Process of maneuvering organizational structures and culture | 2nd order themes |
1st order concepts with exemplary quotations and actions | |
GPs ask for home care services, which cannot be ordered - When (…) discharged from the hospital I experienced her/him as being still very worn out, so I sent a digital message asking them to adjust the care services. | GPs maneuver organizations |
GPs delegate some tasks to home care nurses - S/he had a permanent urinary catheter and I advised it to be changed. So, they have changed it every other month or so. | GPs maneuver organizations |
GPs use other organizations (hospitals) to help initiate services in the local community - I hope s/he can have a higher level of care. I hope the hospital have taken care of that now. Because it’s much harder for me to get it done. | GPs maneuver organizations |
GPs causes home care nurses to withdraw from cooperation when proactive or controlling - I have the impression that if I’m not that proactive, the home care nurses will be more attentive, but it would be nice to have some communication back and have a dialogue (when I’m proactive). | GPs maneuver organizations |
GPs support and see patient autonomy as central - Thus, we don’t do much other than take care of him/her, sort of. But we try to make him/her accountable for his/her own health. | GPs maneuver medical culture |
GPs support patient self-management - No, patients are their own coordinators as long as they are “reasonably well functioning”. | GPs maneuver medical culture |
GPs see themselves as main point of contact and responsibility - I think it is nice that everything is in one place and that responsibility is held by as few as possible. | GPs maneuver medical culture |