Camilla Seljemo

• Seljemo, Camilla; Røise, Olav; Ree, Eline & Wiig, Siri (2025). Supporting Health Care Resilience Through "reflexive Spaces" in Home Care Services: A Multiple Embedded Case Study. Journal of patient safety. ISSN 1549-8417. 21(7), s. 452–459. doi: 10.1097/PTS.0000000000001375. Fulltekst i vitenarkiv
• Seljemo, Camilla; Wiig, Siri; Røise, Olav; Ellis, Louise A.; Braithwaite, Jeffrey & Ree, Eline (2024). How Norwegian homecare managers tackled COVID-19 and displayed resilience-in-action: Multiple perspectives of frontline-staff. Journal of Contingencies and Crisis Management. ISSN 0966-0879. 32(1). doi: 10.1111/1468-5973.12558. Fulltekst i vitenarkiv Vis sammendrag

  A resilient healthcare system is key to responding to sudden crises, such as the coronavirus disease 2019 (COVID-19) pandemic. Homecare services have been an important platform of healthcare delivery during the pandemic, and healthcare staff on the frontlines of homecare have been confronted with major challenges requiring adaptation to sustain high quality healthcare services. Managers' capacities to adapt to disruptions and challenges are important for an adequate response to challenges on the frontlines. To explore healthcare staff's perspectives on managers at different managerial levels (meso-level) handling of the COVID-19 pandemic in Norwegian homecare services. A qualitative multiple case study was designed including four cases. A case was defined as a homecare service within a Norwegian municipality (public organization). Data were collected through 16 interviews with healthcare staff. Interviews were conducted by using a semi-structured interview guide. Healthcare staff reported their managers as proactive, prepared and responded quickly. Present and supportive managers that provided effective and targeted information, and involved staff in decision-making were key to handling the pandemic in Norwegian homecare services. Our results underscore the interaction between healthcare staff and managers at different managerial levels as essential for quickly react, adapt, and resiliently respond to disruptions like the COVID-19 pandemic. Organizations need to have the flexibility to interact across levels and encourage managers to apply strategies for collaboration and staff involvement, especially during a crisis.

• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2023). The role of local context for managers’ strategies when adapting to the COVID-19 pandemic in Norwegian homecare services: a multiple case study. BMC Health Services Research. 23(1). doi: 10.1186/s12913-023-09444-1. Fulltekst i vitenarkiv Vis sammendrag

  Background The COVID-19 pandemic had a major impact on healthcare systems around the world, and lack of resources, lack of adequate preparedness and infection control equipment have been highlighted as common challenges. Healthcare managers’ capacity to adapt to the challenges brought by the COVID-19 pandemic is crucial to ensure safe and high-quality care during a crisis. There is a lack of research on how these adaptations are made at different levels of the homecare services system and how the local context influences the managerial strategies applied in response to a healthcare crisis. This study explores the role of local context for managers’ experiences and strategies in homecare services during the COVID-19 pandemic. Methods A qualitative multiple case study in four municipalities with different geographic locations (centralized and decentralized) across Norway. A review of contingency plans was performed, and 21 managers were interviewed individually during the period March to September 2021. All interviews were conducted digitally using a semi-structured interview guide, and data was subjected to inductive thematic analysis. Results The analysis revealed variations in managers’ strategies related to the size and geographical location of the homecare services. The opportunities to apply different strategies varied among the municipalities. To ensure adequate staffing, managers collaborated, reorganized, and reallocated resources within their local health system. New guidelines, routines and infection control measures were developed and implemented in the absence of adequate preparedness plans and modified according to the local context. Supportive and present leadership in addition to collaboration and coordination across national, regional, and local levels were highlighted as key factors in all municipalities. Conclusion Managers who designed new and adaptive strategies to respond to the COVID-19 pandemic were central in ensuring high-quality Norwegian homecare services. To ensure transferability, national guidelines and measures must be context-dependent or -sensitive and must accommodate flexibility at all levels in a local healthcare service system.

• Ree, Eline; Wiig, Siri; Seljemo, Camilla; Wibe, Torunn & Lyng, Hilda Bø (2022). Managers’ strategies in handling the COVID-19 pandemic in Norwegian nursing homes and homecare services. Leadership in Health Services. ISSN 1751-1879. doi: 10.1108/LHS-05-2022-0052. Fulltekst i vitenarkiv Vis sammendrag

  Purpose This study aims to explore nursing home and home care managers’ strategies in handling the COVID-19 pandemic. Design/methodology/approach This study has a qualitative design with semistructured individual interviews conducted digitally by videophone (Zoom). Eight managers from nursing homes and five managers from home care services located in a large urban municipality in eastern Norway participated. Systematic text condensation methodology was used for the analysis. Findings The managers used several strategies to handle challenges related to the COVID-19 pandemic, including being proactive and thinking ahead in terms of possible scenarios that might occur, continuously training of staff in new procedures and routines and systematic information sharing at all levels, as well as providing different ways of disseminating information for staff, service users and next-of-kins. To handle staffing challenges, managers used strategies such as hiring short-term staff that were temporary laid off from other industries and bringing in students. Originality/value The COVID-19 pandemic heavily affected health-care systems worldwide, which has led to many health-care studies. The situation in nursing homes and home care services, which were strongly impacted by the pandemic and in charge of a vulnerable group of people, has not yet received enough attention in research. This study, therefore, seeks to contribute to this research gap by investigating how managers in nursing homes and home care services used different strategies to handle the COVID-19 pandemic.

• Seljemo, Camilla; Viksveen, Petter & Ree, Eline (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: a cross-sectional study. BMC Health Services Research. 20. doi: 10.1186/s12913-020-05671-y. Fulltekst i vitenarkiv Vis sammendrag

  Background Transformational leadership style is considered to be of importance to increase patient safety, to facilitate a balance between job resources and job demands, and to create a sound patient safety culture within health care services. However, there is limited research assessing these associations within the context of nursing homes. The aim of this study was to assess the association between transformational leadership, job demands and job resources; and patient safety culture and employees’ overall perception of patient safety in nursing homes. Method A cross-sectional survey of employees in four Norwegian nursing homes was conducted (N = 165). Multiple hierarchical regression analysis was used to assess the explained variance of transformational leadership, job demands and job resources on patient safety culture and overall perception of patient safety. Results Transformational leadership explained 47.2% of the variance in patient safety culture and 25.4% of overall perception of patient safety, controlling for age and gender (p < 0.001). Additionally, job demands and job resources explained 7.8% of patient safety culture and 4.7% of overall perception of patient safety (p < 0.001). Conclusion Implementing transformational leadership style may be important in creating and sustaining sound patient safety culture in nursing homes. Furthermore, leaders should make an effort to facilitate a good work environment with an optimal balance between job demands and job resources, as this in turn might have a positive influence on patient safety culture.

Se alle arbeider i NVA

• Seljemo, Camilla (2024). Managing a crisis across levels - A resilience perspective on homecare managers` handling of the COVID-19 pandemic. Fulltekst i vitenarkiv
• Seljemo, Camilla; Ree, Eline; Røise, Olav & Wiig, Siri (2024). Managers` leveraging reflexive spaces in resilient healthcare. Fulltekst i vitenarkiv
• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2023). The role of local context for managers` strategies when adapting to the COVID-19 pandemic. Managerial strategies across system levels in Norwegian homecare services. Fulltekst i vitenarkiv
• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2023). Exploring managers` role in resilient healthcare during the COVID-19 pandemic in Norwegian homecare services. A- multiple embedded case study. Fulltekst i vitenarkiv
• Seljemo, Camilla (2022). Ledelse i pandemiens tid. Fulltekst i vitenarkiv
• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2022). The role of local context for managers` experiences and strategies applied when adapting to the COVID-19 pandemic in Norwegian homecare services - A multiple case study in four Norwegian municipalities. Fulltekst i vitenarkiv
• Ree, Eline; Wiig, Siri; Seljemo, Camilla; Wibe, Torunn & Lyng, Hilda Bø (2022). Managers’ strategies in handling the Covid-19 pandemic in Norwegian nursing homes and homecare services. Fulltekst i vitenarkiv
• Ree, Eline; Wiig, Siri; Seljemo, Camilla; Wibe, Torunn & Lyng, Hilda Bø (2022). Lederes strategier for å håndtere Covid-19 pandemien i sykehjem og hjemmetjenesten. Fulltekst i vitenarkiv
• Seljemo, Camilla (2021). Exploring managers` role in resilient healthcare during the COVID-19 pandemic. Fulltekst i vitenarkiv
• Seljemo, Camilla (2021). Managers` experiences from handling and adapting in response to the COVID-19 pandemic in homecare services. Fulltekst i vitenarkiv
• Seljemo, Camilla; Ree, Eline; Wiig, Siri & Røise, Olav (2025). Exploring homecare managers’ role in resilient healthcare during the COVID-19 pandemic: A multiple embedded case study. Universitetet i Stavanger. ISSN 9788284394206. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: The COVID-19 pandemic has been one of the most significant challenges faced by healthcare systems in modern times, with homecare services playing a critical role in the delivery of care to patients at home. Providing healthcare in homecare settings is inherently complicated, given the combination of patients’ often complex medical conditions, the use of advanced technologies, and the limited support available from managers and colleagues due to remote working conditions. During the pandemic, homecare staff faced numerous challenges that required continuous adaptation to maintain essential healthcare services. Managers’ capacity to respond to disruptions and support frontline staff was crucial for ensuring safe and effective care. Homecare managers faced a range of organizational challenges that threatened service quality, requiring flexible, innovative, and adaptive strategies. These practices reflect the core characteristics of resilience in healthcare organizations: the capacity to respond to uncertainty, adapt, and maintain effective functioning amid adversity. However, gaps remain in our understanding of the specific strategies managers employ across system levels, how they foster organizational learning, and how they contribute to resilient healthcare delivery within the homecare sector in times of crisis. Aim: The overarching aim of this thesis was to advance the understanding of managers’ role in fostering resilience within homecare services by exploring the strategies employed at different managerial levels in response to the challenges of the COVID-19 pandemic. This exploration was conducted from the perspectives of both homecare managers and healthcare staff. A secondary aim was to investigate how managers facilitated spaces for reflection and knowledge-sharing, referred to as “reflexive spaces”, and how these spaces contributed to support resilience performance during the pandemic. Methods: This thesis employed a multiple embedded case study design, comprising three qualitative studies that explored managerial strategies in homecare services during the COVID-19 pandemic, from the perspectives of both managers and frontline staff. The study included four municipalities of various sizes and geographical contexts (urban, rural, centralized, and decentralized). Each case was defined as a municipality’s homecare unit, comprising embedded units at several levels: micro-level healthcare staff, meso-level managers (frontline, middle, and top), and the municipality’s infection control doctor. Data were collected through individual semi-structured interviews with 21 managers and 16 healthcare staff. All data were subjected to thematic analysis. Results: Paper I (meso-level) explored which strategies managers applied in adapting to challenges while maintaining high-quality and safe homecare services during the COVID-19 pandemic, and how their experiences and strategies were shaped by the local context. The analysis identified four main themes: 1) managerial strategies to mitigate shortages of healthcare staff; 2) contingency planning strategies and infection control; 3) strategies for collaboration, dialogue and coordinated responses across levels; and 4) supportive and present leadership. The local context was important for managers experiences and which strategies they applied in response to the challenges caused by the pandemic. Paper II (micro-level) explored healthcare staff’s experiences of how their managers adapted and responded to the challenges posed by the pandemic in homecare services. The analysis identified the following three themes: 1) proactive managers’ preparedness and response to challenges despite uncertainty; 2) the importance of targeted and effective information between system levels; and 3) physically present managers made employees feel seen, heard and involved. Paper III (micro- and meso-level) explored how managers facilitated knowledge-sharing and joint reflections and how these “reflexive spaces” contributed to adapting to the pandemic. The analysis identified two main themes 1) arenas for reflection, communication and dialogue and 2) establishing new solutions through collective reflection facilitated by managers. The synthesis of findings across the three papers identified six themes that explain homecare managers’ role in resilient healthcare during the COVID-19 pandemic: 1) proactively responding despite uncertainty; 2) driving crisis innovation; 3) being present, available and supportive; 4) adapting to local context; 5) ensuring collaboration and information across levels and boundaries; and 6) enabling collective reflection, problem-solving and learning. Conclusion: This thesis uses a resilience perspective to generate valuable insights into Norwegian homecare service managers’ role in handling a pandemic. Managers at all levels of the organization faced continuous and complex Challenges that threatened the delivery of highquality and safe care. In response, they demonstrated adaptability both within and across levels by making sense of evolving situations, monitoring developments, and anticipating potential scenarios. This enabled them to mobilize and innovate using both existing and new resources. At the same time, they evaluated and improved their strategies and enabled learning across levels and boundaries, allowing for restructuring and reorganizing the system to better prepare the system for future responses to challenges. This emphasizes the importance of managers in enabling organizational learning and system-level interaction during a crisis. Future efforts should aim to support and strengthen local adaptive strategies in response to emerging challenges, with a particular emphasis on cross-level and cross-context learning to drive system-wide improvement.

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