Background Frail older adults constitute a significant vulnerable group with complex healthcare needs requiring collaboration between various care providers and professions. Despite this requirement, there are considerable knowledge gaps in how to achieve effective collaboration. Preventive measures such as addressing pressure ulcers, falls, malnutrition and poor oral health often receive low priority compared with treating diseases or injuries. This study aims to enhance our understanding of how care collaboration in the preventive care process (PcP) using the Senior alert (SA) register could improve patient safety and equality of care for frail older adults in Sweden.

Methods This study, conducted over 4 years, employs an explanatory mixed methods design, divided into three phases. The study protocol comprises the two first phases.

Phase 1 (quantitative) Data from SA (2019–2021) will be analysed to compare municipalities regarding the quality of registration in the PcP. Municipalities with high and low compliance indices will be identified and analysed together with data on demographics, socioeconomics and organisation from Statistics Sweden.

Phase 2 (qualitative) Focus group interviews will be conducted in residential care units in the municipalities identified in phase 1 with interprofessional teams and older persons/next of kin. Additionally, 30 semi-structured individual interviews with residential care managers and other relevant stakeholders will explore obstacles and opportunities for effective care collaboration.

Discussion We foresee that the results will contribute to the development of a model for effective PcP and care collaboration that can be used to improve patient safety and quality of care for frail older adults. This model can be tested and upscaled to achieve a more effective and equitable healthcare system.

Ethics and dissemination The study has been approved by the Swedish ethical review authority. Dissemination plans involve publications, data deposition and engagement with healthcare stakeholders to ensure the practical application of the findings.

Skolutveckling för hållbart lärande utgår från ett helhetsperspektiv på skolutveckling. Det handlar om att se till elevens hela lärande­situation där både välbefinnande och bildning står i centrum, men också om att engagera hela skolan i ett multiprofessionellt utvecklingsarbete. I boken beaktas såväl betydelsen av styrdokument, lokala förut­sättningar och en utbildning på vetenskaplig grund och utifrån beprövad erfarenhet. Syftet är att medverka till hållbara kunskaper och människor samt bidra till en hälsofrämjande arbetsplats. Boken innehåller både teoretiska och praktiska perspektiv på skol­utveckling integrerat med ett konkret exempel från ett forsknings- och utvecklingsprojekt om hållbart lärande. Den vänder sig till verksamma på alla nivåer som arbetar med skolutveckling och till rektors- och lärarutbildningen.

Purpose - The aim of this paper is to identify the role of the principal in establishing a whole school approach for health and wellbeing. Two questions are asked: (1) What do successful Swedish principals do when they take on a whole school approach? (2) How do these results relate to previous research on successful school leadership?

Design/methodology/approach - This paper focuses on the complexity of organisational processes and considers the role of successful leadership in managing a whole school approach to health promotion. It presents findings from two different but interlinked projects, and draws on document studies and interviews with principals, student health team members and teachers in Sweden.

Findings - This paper argues that successful school leaders are crucial in establishing a whole school approach, because of the work they do to synchronise the health-promoting activities in schools. The study identifies four aspects of coordination that need to be enacted simultaneously when leading health-promoting processes. The fifth aspect identified is that a whole school approach is not limited to the school, but the whole local school context, i.e. a synchronisation between different system levels.

Originality/value - Although limited in scale, this paper reports key findings that could have practical implications for school leaders. The study suggests that successful school leadership research needs to use a health-promoting lens in order to make leadership practices health-promoting practices. It also proposes extended comparative research from different fields and contexts.

Den här rapporten är en uppföljande studie efter att elevhälsoteam och rektorer från 19 skolor deltagit i Specialpedagogiska skolmyndighetens kurs ”Att höja skolans elevhälsokompetens – ett processarbete för likvärdig utbildning”. Studien visar att kursen fungerar som ett betydelsefullt stöd för att utveckla ett hälsofrämjande och förebyggande elevhälsoarbete.

Studien tar sina teoretiska utgångspunkter i teorier om ledarskap i skolan och teorier om teamutveckling. I rapporten beskrivs två modeller: en för samordning av skolans elevhälsoarbete och en för utveckling av elevhälsoteam. Avslutningsvis beskrivs hur dessa kan användas för att förstå och identifiera grundläggande förutsättningar för ett främjande och förebyggande elevhälsoarbete som uppfattas positivt av såväl elevhälsoteam som rektorer, lärare och övrig skolpersonal.

Studien pekar på vikten av samordning av alla delar för att kunna utveckla ett mer förebyggande och hälsofrämjande arbetssätt i hela skolan. Resultatet visar att elevhälsoarbetets komplexitet och kontext behöver ligga till grund för skolors utvecklingsarbete. Rektors ledarskap, elevhälsoteamens utveckling samt samverkan mellan elevhälsoteam, lärare och övrig skolpersonal är centrala delar som behöver synkroniseras. För ett mer hållbart elevhälsoarbete över tid blir det även viktigt att fokusera på huvudmannens ansvar och delaktighet i utvecklingsarbetet.

Principals have been identified as key actors for students’ performance. Accordingly, how leaders affect classroom activities has also emerged as a research field. One basic argument is that principals should focus on activities that can affect students’ learning outcomes. In particular, they should develop their instructional leadership, close to the core activities of teaching. However, schooling does not only consist of classroom activities – students, teachers and other professionals spend a lot of time in school long after the bell has rung. In this chapter we explore the potential benefits of considering schools not only as places for knowledge production towards academic achievement, but as a whole study environment that includes multiple spheres of activity and learning. We argue that, while the inner sphere is given a lot of leadership attention, there are several reasons for principals to also discover what we call the outer and middle spheres of schools and education. We consider the complexity of the local school context as the fundamental but forgotten, or unexplored, aspect of school leadership. 

Buscando mirar desde la práctica directiva real, el siguiente artículo plantea la necesidad de visibilizar a las escuelas como sistemas complejos de acciones y eventos no lineales e impredecibles, rasgos que ningún líder escolar debiera dejar de atender. Ello implica gestionar con equilibrio los múltiples factores que inciden en el quehacer diario de los directivos, con la misión y metas de la escuela. Desde la narrativa de líderes escolares exitosos en Suecia, los autores destacan algunos aspectos comunes de sus relatos: visión amplia y holística de la educación, una cuidadosa atención al contexto, conciencia avanzada del rol de la comunicación, una relación dialógica entre liderazgo y aprendizaje y, sobre todo, la capacidad de asumir la complejidad intrínseca de su tarea.

A newborn interest in and growing recognition of school leadership and school leaders in education is reflected in a converging global policy climate geared to higher performance and better results in schools. School leaders are no longer chiefly seen as administrators; rather, they are expected to be learning oriented school leaders and to play crucial roles in student achievement, teacher performance, school improvement and in effective school reform. This development has prompted debate on the knowledge base of school leadership, but also tensions with regard to the general expectations of and the concrete contexts for school leadership. In this paper, we examine and analyze the narratives of Swedish principals in vocational education and training as they face the challenges and growing expectations of embracing (instructional) leadership for teaching and learning in their work. We discuss the growing global interest in school leadership for teaching and learning, or instructional leadership, and its growing institutionalization, and we define what we mean by organizational complexity as a fundamental trait of schools and an inescapable condition for school leadership. We suggest that school leadership in vocational education and training often is subject to organizational hyper-complexity, and that effective school leaders in vocational education and training must be able to manage a variety of intermingling tasks and contexts in their schools. School leadership for teaching and learning in vocational education and training can be seen as the art of embracing, using and mastering organizational complexity.