Busy times and new ventures in social welfare and healthcare development
Timo Sinervo, D.Soc.Sc. (Doctor of Social Sciences), Docent at University of Tampere, Research Manager, Research in social welfare and healthcare, National Institute for Health and Welfare
The social welfare and healthcare sector is undergoing a tremendous upheaval. The government’s social and healthcare reform naturally is the most important driver of this change, but even without it, the sector has changed and will be changing at a fast pace. The local government sector, which has been considered rigid, is in a state of constant flux on closer inspection.
The social and healthcare reform remains difficult to fathom, as many details are still missing. It seems obvious, however, that the county will be responsible for organising the services, while their provision will be entrusted to publicly owned enterprises and private companies.
The social and healthcare reform is a combination of an extremely extensive merger, launch of completely new activities (the counties as a government organisation and organisers of social and healthcare services), large-scale corporatisation as well as introduction of new practices (freedom of choice, personal budgeting). A merger in which over 200,000 employees will be looking for their new roles and thousands of directors for their positions would be a challenging task as such. Merely getting salaries paid in January 2019 and ensuring that customers can access services without disruptions would be a sufficient goal. In most mergers the operative changes are carried out at a later stage, whereas in the beginning, the merger is mainly a technical step.
If the draft acts are passed more or less in their current form, functions performed by public enterprises (hospitals, social work, specialised services, public administration activities) could in principle continue as before in many respects. However, it is likely that the organisation and management structures will change, and in the initial phase, this will create a lot of confusion; what will we do now, where do I get a new keyboard or a mouse when the old ones no longer work? Renewal of practices is naturally needed in all activities, and cooperation structures also keep changing.
Corporatisation will be a significant change for the employees in social welfare and health centres, services for older people and many others. Competing for customers is a new venture for the public sector, and it is likely that the social and healthcare centres, at the very least, will unavoidably lose some of their customers as new actors enter the market. The public sector is way behind and only establishing its companies, while private actors are already staking their claims in the market and getting ready for action. The public sector is accustomed to thinking of how customers could cope with as few services as possible, and attracting customers is a new challenge. Customer service and seeing the customer’s problems as a whole could be an area in need of development.
However, the structures are only the beginning, and the most essential challenge is still ahead: how to develop services that are more customer-responsive?
The reform will take a long time to complete, even after the new organisations are up and running. It is likely that fast consultations and solutions to practical problems will be needed in the midst of the change. Hopefully, one of the stakeholders can also find money for carefully monitoring the change. Failing to study the greatest change project of the last few decades would be a pity – and the studies should also focus on the process of change, not only the end result.
Once the structures have been sorted, the practices will be renewed. In order to support the change, there will certainly be demand for different types of development and research: consultants, research institutes, universities and universities of applied sciences alike. It is likely that development projects will be needed to come up with new operating models – combined with training, consultations, evaluation and benchmarking. As they are close to the labour market, the universities of applied sciences will play a key role in this. The question is how we can make the most of this cooperation with the world of work.
At this point, we should strain our ears and listen carefully to labour market needs. As the actors change, contacts in many areas need to be re-established. A public sector service provider will in many cases be replaced by a company owned by the private or the public sector. Will this change anything? What competence will be needed in the future, and how can education, training and development respond to future needs? How can attitudes and practices be reformed? What new competence will the current social and healthcare professionals need in the future? And do the current degree programmes have what it takes? If we aim for cooperation between social welfare and healthcare, should this cooperation also be more prominent in education?
If the social and healthcare reform follows the course plotted by the draft act on the freedom of choice, the services will be increasingly fragmented and provided by a greater number of actors. On the other hand, the counties will marshal activities that are scattered around the municipalities. As services are provided by companies and public enterprises of different owners, there will be greater need for service coordination and counselling. Up till now, flexible service chains responding to customer needs and teams of professionals have been created mainly by bringing the professionals together in the same organisation or facilities – even if this development is still in its early stages.
The majority of the resources are provided for customers who use a lot of services of many different types. It is thus clear that we must invest in services for this customer group. A change in practices and attitudes is needed to avoid a situation where we only look after an older person’s left knee. We should also consider how the older person, who is living alone and also otherwise is in a poor condition, can manage after a knee operation at home, on the second floor of a house with no elevator. The customer’s other service needs should also be assessed, and we should establish where these other services for the customer can be obtained.
In the future, we must increasingly build service chains between different actors. The difference is that the next link in the service chain will no longer be managed by another unit of the municipality. Instead, the customer should choose the physiotherapist or home care company that he or she wishes to do business with. Who will take care of this task and where? The county, the public enterprise or the companies that provide services? Do experts with sufficient knowledge of both social welfare and healthcare services exist to manage customer guidance or service coordination? Do the current experts consider the customer’s needs with a sufficiently holistic approach? And how can we persuade the service providers in the counties to work in line with the objectives set by the county?
A recurring problem in development and research efforts has been that the projects are small and disjointed. The municipalities already are up to their ears in projects of this type. The reason for this often is that research and development organisations have to work within the framework conditions set by funding: the actors research or develop whatever they can get funding for. This does not always serve the needs of the customers or providers of services.
Is it perhaps time to consider how different types of funding could be used to create more extensive projects between several actors that would genuinely serve the needs of the counties and service providers?
Partnerships on many fronts
Anu Niemi, Lic.Med., Development Director, Siun sote
Sari Salminen, MHS, Nursing Director in charge of teaching, Siun sote
Mari Matveinen, MHS, Teaching and Research Coordinator, Siun sote
Tuula Kukkonen, Dr.Soc.Sc., Principal Lecturer, Karelia University of Applied Sciences
Anneli Muona, MSc (Sports), Lecturer, Karelia University of Applied Sciences
Päivi Sihvo, MHS, Lecturer, Karelia University of Applied Sciences
Tuomas Lappalainen, M.Soc.Sc., Development Manager, Karelia University of Applied Sciences
The Karelia University of Applied Sciences, the North Karelia Educational Community and the North Karelia Social and Health Services, Sensate, have entered into a strategic partnership agreement in February of 2016. The strategic partnership is based on the parties’ strong expertise, mutual trust and benefit for all parties involved. Through this new cooperation methods, new multidisciplinary approaches, such as on-the-job learning and training as well as joint development projects were created.
Through this project, for example, new home care models and strengthening the digital competences of social and health professionals will develop.
Management in the social services and health care sector in the future
Terhi Laine, D.Soc.Sc., Director of Innovations, Diaconia University of Applied Sciences
Ilse Vogt, M.Ed, Regional Cordinator, Diaconia University of Applied Sciences
Social welfare and health care reform will change the structure of services in Finland. This article focuses on social services and health care management today and in the future. The data was collected from Master’s Degree students who work at social services and health care sector. Some of them were in leadership position in their working places. In data collection there were four reflective group discussions which were recorded and littered. The analysis was based on the content analysis.
The analysis indicates that there is the basis of management which describes the situation of today. It consists of interaction, declaration of core tasks, capacity to do decision making capacity and development of know-how. We can find those elements also in the future of management in the social services and health care sector. Furthermore there will be enhanced other issues such as coaching, remote leadership, leadership of interprofessional networks, management by knowledge and communication skills of manager. These elements are important in ongoing social welfare and health care reform, which requires change management.
Front-line management studies develop mentoring in supervisory work
Arja-Irene Tiainen, Principal Lecturer, PhD (Education), MHS, Specialist Nurse, Karelia University of Applied Sciences
Jaana Pasanen, Assistant Head Nurse, Specialist Nurse, Supervisor, Siun sote/PKKS
The demands for health care managers’ competence have grown. Many first-line managers in the field of health care have recognised the need for supplementary leadership education. At Karelia University of Applied Sciences, we wanted to meet this demand by developing leadership education for first-line managers in health care (60 ECTS). This article describes a practical mentoring assignment conducted by a leadership student. Mentoring is one of the oldest development methods for transferring silent knowledge from a mentor to an actor. Mentoring is useful for both the mentor and the actor since both will learn and develop themselves during the mentoring process. One part of the leadership education at Karelia UAS is the course Human Resource Management. During this course, the student’s task was to start a mentoring process at the intensive care ward she was working at as a Head Nurse. Previously, mentoring had been used at this ward, but it was not currently in use. The article describes the student’s work on re-introducing mentoring at the ward as part of first-line management. Mentoring can be seen as one method of contributing to the wellbeing of employees in the field of health care.
Competence related to procurement supports a successful social and healthcare reform
Esa Väänänen, Licentiate of Science (Economics), M.Sc. (Tech.), Lecturer, Metropolia University of Applied Sciences
Erja Turunen, Licentiate of Science (Economics), Principal Lecturer, Metropolia University of Applied Sciences
In this article, a significant competence challenge is presented for organisations both in the private and public sector as they take part in the implementation of a major societal change, namely the renewal of the social and health care sector in Finland. In his recent doctoral dissertation, the main author argues: procurement competence is needed and its significance is not sufficiently known nor appreciated in organisations. Many of the best practices utilized in the private sector can be transferred to the public sector. Similar conclusions appear in Master’s Theses he has supervised. The second author is a colleague interested in RDI activities of universities of applied sciences and has closely observed the development and implementation of a Master’s degree programme in Supply Chain Management (Procurement) led by the main author.
Reinforcing the well-being and social inclusion of young people
Kati Peltonen, Dr.Sc. (Econ.), MEd, RDI Director, Lahti University of Applied Sciences
Minna Elomaa-Krapu, Dr.Sc. (Nutr.), Head of Master’s programmes in health, Metropolia University of Applied Sciences
Anne Määttä, D.Soc.Sc., Senior Specialist in service system development, Diaconia University of Applied Sciences
Minna Kahala, Dr.Sc. (Nutr.), Lecturer, Satakunta University of Applied Sciences
Marko Kananen, PhD, Researcher, South-Eastern Finland University of Applied Science
A majority of young people in Finland are feeling well, but at the same time a number of young people facing unemployment and situations of social exclusion and poverty is increasing alarmingly. This article opens up the multilayered concept of inclusion and addresses different dimensions which are intertwined and constitute and have effect on young people’s subjective experiences on their wellbeing and social inclusion. The article brings up the crucial role of psychological factors such as resilience, coherence and self-beliefs in enhancing youth mental wellbeing.
Social, Mental and Body – More together
Marjo Keckman, MHS, Lecturer, Satakunta University of Applied Sciences
Tiina Mikkonen-Ojala, MHS, Lecturer, Satakunta University of Applied Sciences
Mari Törne, MHS, Lecturer, Satakunta University of Applied Sciences
The university of applied sciences (UAS) students have different forms of studies. Most students handle the work load well and their experienced health is good. However, psychosomatic problems have increased among UAS students. SomeBody® method was invented to meet the students’ needs and SomeBody groups have been provided for SAMK students. This method combines body awareness, emotional and social skills. The focus is on awareness of and relationship with the surrounding people and society. The course participants get tools to cope with stress and social situations. They learn ways to react physically, mentally and socially and to express their emotions. An ability to recognize one’s own resources and strengths is also needed at work in the future. Health care professionals should be able to guide the clients towards their own resources and self-reflection. SomeBody® method is still being developed in order to better response to the needs of the UAS students’ well-being.
Developing well-being services together – customer first
Birgitta Lehto, Dr.Sc. (Nutr.), Nurse, Lecturer, Saimaa University of Applied Sciences
Minna Taipale, Bachelor of Culture and Arts, Specialist, Humak University of Applied Sciences
The Agency of Cultural Wellbeing is a three-year-long project coordinated by Humak University of Applied Sciences in cooperation with Saimaa and Turku Universities of Applied Science.
The Agency of Cultural Wellbeing wants to bring together the customers and providers of inclusive art. It’s main goal is to promote equal access to arts and culture. Cooperation between universities of applied science can offer wide range of networks, Up-to-date R & D know-how and international contacts.
The Agency of Cultural Wellbeing is training artists, cultural producers and professionals of social services and health care to work together to create new art based products especially for the use of social services and health care. Good example of our work is TUNNE I KEHO –method created by multiprofessional group during the training. Method was developed together with customers of mental care basing on their needs.
Olopiste teaches students to take a closer look at long-term unemployed people
Helena Hatakka, Lic.Ed., Principal Lecturer, Lahti University of Applied Sciences
Erno Hokkanen, Bachelor of Business Administration, Project Manager, Harjula Settlement
Tarja Kempe-Hakkarainen, M.Ed., Lecturer, Lahti University of Applied Sciences
Pasi Viitaniemi, Practical Nurse, Supervisor, Kaupunkikylä Sylvia-koti yhdistys ry
The ESR funded (2015-2018) project Olopiste (S20362), which is a non-threshold support action for long-term unemployed and socially excluded people. It aims to strengthen the participants’ abilities to participate in society’s normal activities. It also aims to strengthen their working abilities and well-being through support and provided activities. There are both individual and group activities for clients in Olopiste. Bachelor of social services students are implementing these activities together with the staff. Olopiste is also an authentic learning environment. Clients have been involved in evaluation of Olopiste´s activities. Generally, they are content with the current activities. Developmental activities have lately focused on marketing and finding more clients. Next the individual counselling work and how to maintain Olopiste as a service after the project are the main issues. Partners are Harjula Settlement, Lahti University of Applied Sciences and SylviaKoti Association/Kaupunkikylä.
Results by genuine cooperation -Occupational therapy group as a boundary object
Jennie Nyman, Master of Medical Sciences in Occupational Therapy, Teacher in Occupational Therapy, Metropolia University of Applied Sciences
Sanna Piikki, Master of Health Sciences, Teacher in Occupational Therapy, Metropolia University of Applied Sciences
Is it possible to teach students and serve working life partners at the same time? This was the main question we asked ourselves as we started to plan a new way of carrying out a course on group leading skills for occupational therapy students. As teachers at Metropolia University of Applied Sciences we wanted to include the task of addressing the needs of the working life as a key component of our course.
In this article we describe our choices when planning a course that provides services for working life partners, enhances the learning for our students and uses the teachers’ resources effectively, all at the same time. The most central decision was to involve working life partners already in the theoretical studies. We also found it to be very important that the students get firsthand experience of planning and leading a group and that they get the possibility to learn from each other’s experiences as well. We designed a course where the students work in pairs when planning and carrying out occupational therapy groups in different work environments. The students share experiences with each other, and the teachers’ role is to provide support and supervision along the way.
Increased well-being through 3D technologies
Hannu Hyyppä, Professor of Measuring and Modeling, D.Sc., Head of the Institute, Aalto University, Humak University of Applied Sciences
Marika Ahlavuo, Science Producer, Coordinator, Cultural Pruducer, Aalto University, The Research Institute of Modeling and Measuring for the Built Environment (MeMo), Humak University of Applied Sciences
Matias Hyyppä, Student of Technology, Aalto University
Kaisa Jaalama, urban designer, M.Sc (Public administration), Aalto University, MeMo
Matti Kurkela, Studio Manager, Lic.Tech., M.A., Aalto University, MeMo
Juho-Pekka Virtanen, Doctoral Student, M.A., Aalto University, MeMo
Jussi-Matti Kallio, Project Coordinator, Seinäjoki University of Applied Sciences
Matti Vaaja, Postdoctoral Researcher, D.Sc., Aalto University, MeMo
Petri Rönnholm, Senior University Lecturer, D.Sc., Aalto University
Arttu Julin, Doctoral Student, M.Sc., Aalto University, MeMo
Juha Hyyppä, Professor, D.Sc. (Tech), National Land Survey of Finland’s Geospatial Research Institute
Digitalization transforms health and social care. Explicit measurements of the living environments as well as of human bodies can be assisted by 3D technologies that have become increasingly cheap over the years.
Digital footprint can now be analyzed and applied in new kind of products for the purposes of well-being and health. Individual measuring becomes global. Means of moving as well as knowledge of surrounding environment and its possibilities will increase. Emerging technologies combine measuring and time dimension that enables tracking changes in human bodies and in the surrounding environment effortlessly. Technology slowly merges to the environment and changes the way individuals evaluate their well-being in their everyday life, work and living. Conclusions were made in technological pilots and vision work generated by Humak University of Applied Sciences, Metropolia University of Applied Sciences, Seinäjoki University of Applied Sciences and Aalto University.
With a cross-sectoral approach, everyone is a winner!
Andrew Sirkka, PhD (Education), Principal Lecturer, Satakunta University of Applied Sciences
Sari Merilampi, Dr.Sc. (Tech.), Senior Researcher, Satakunta University of Applied Sciences
Krista Toivonen, Lecturer, Team Leader, Sataedu
Shared cross-sectoral expertise is required to attain optimal benefits from technology potential in health and welfare service development. Wellbeing Enhancing Technology research group (WET) at Satakunta UAS (SAMK) actively and intentionally integrates RDI with education (and vice versa) utilizing cross-sectoral and cross-national expertise. RDI activities take place in close collaboration with a great number of working life organisations, entrepreneurs, students and international partners. Based on the feedback, crossing sectors and levels of education as a genuine conjunction of action is motivating all parties. Exposing oneself and bringing one’s own frame of reference into seeking the optimal solutions generates actors and innovators with novel skills.
Could mobile applications have a role in evidence-based customer work in the social and healthcare sector?
Mari Punna, MHS, Lecturer, JAMK University of Applied Sciences
Essi Heimovaara-Kotonen, MHS, Project Specialist, JAMK University of Applied Sciences
The use of digital methods has increased worldwide within health and social services’ client counselling. Mobile applications are forecasted to be a key factor in developing current services and creating opportunities for new kinds of services. However, all the new mobile applications do not correspond to evidence-based care or well-being promotion.
In Me First –project a tool for assessing health and well-being mobile applications has been created in co-operation with developers and social- and healthcare professionals, utilizing previous research. The developed assessment tool can be used in mobile application assessment to respond to individual needs of patients.
The assessment tool consists of three sections evaluating the mobile application: 1) contents of health and well-being counselling, 2) usability, and 3) information security and safety of usage.
Using existing health and well-being mobile applications with clients and patients is an interesting future opportunity to increase client-centered working methods.
Shaping the transformation of well-being
Leena Unkari-Virtanen, DMA, Metropolia University of Applied Sciences
Eeva Tawast, MA (Psych), psychologist specialising in developmental and family counselling, Metropolia University of Applied Sciences
Jari Pihlava, MHS, Psychotherapist with advanced level of competence, occupational therapist, Metropolia University of Applied Sciences
Päivi Eskelinen-Roos, MEd, Metropolia University of Applied Sciences
Raili Honkanen-Korhonen, Lecturer, Master in Music Pedagogy, playback theatre director, Metropolia University of Applied Sciences
The historic but empty psychiatric hospital of Lapinlahti, Helsinki, was turned into a centre of mental wellbeing in a project called Join at Lapinlahden Lähde 2015-2017. Metropolia University of Applied Sciences was part of the project and provided a team of experts, which task was first to observe the functions of project and, in turn, to create a concept of wellbeing that can be duplicated and transferred in to other old, empty spaces and buildings. In the team lecturers of varied areas of culture and social wellbeing brought different perspectives on the concept. Starting point of the concept design was positive psychology. This concept of mental wellbeing consists of three parts: narrative, visual and functional parts.
Lypsylove promotes well-being in rural areas 2025?
Johanna Hautamäki, MA, Project Manager, Centria University of Applied Sciences
Annukka Tapani, D.Soc.Sc., Principal Lecturer, Tampere University of Applied Sciences
Minna Sipponen, Bachelor’s Degree in Hospitality Management, Tourism (YAMK), lehtori, Lapland University of Applied Sciences
Leila Kakko, MMM, lehtori, Tampere University of Applied Sciences
This article describes, through a practical example, how a UAS can act as a partner with working life in developing welfare services. A workshop was organized in co-operation between three UAS’s, where hospitality management students brainstormed to come up with ideas for future welfare services in rural areas using service design methods. This workshop is part of a longer anticipation process that is carried out at Centria UAS together with working life partner, ProAgria Ostrobothnia.
The workshop was organized at Tampere UAS, bringing together 39 third year students. The aim was to get new ideas and perspectives. The workshop resulted in eight services ideas. Four of them focused on enhancing digital services, two on increasing meeting and exchanging know-how and two on building on nature’s possibilities.
Increased well-being through 3D measurement of green infrastructure in the living environment
Kaisa Jaalama, urban designer, MHS, Aalto University
Hannu Hyyppä, Professor of Measuring and Modeling, D.Sc., Head of the Institute, Aalto University, Humak University of Applied Sciences
Marika Ahlavuo, Science Producer, Coordinator, Cultural Pruducer, Aalto University, Humak University of Applied Sciences
Satu Räty, BA, Aalto University
Arttu Julin, Doctoral Student, M.Sc., Aalto University
Juho-Pekka Virtanen, Doctoral Student, M.A., Aalto University
Matti Kurkela, Studio Manager, Lic.Tech., M.A., Aalto University
Matti Vaaja, Postdoctoral Researcher, D.Sc., Aalto University
Wellbeing and the quality of the living environment are being enhanced by the assistance of emerging 3D technologies. This will be seen as 3D technology assisted everyday life services but also as 3D spatial information, that can be used in increasing the quality of the living environment. We are developing indicators based on spatial information and 3D technologies that work as a tool in evaluating existing green infrastructure, quality and attractiveness of the residential and urban areas. Important questions are how 3D spatial information can be combined with empirical and residents’ knowledge, and how this information can be applied in urban planning and services.