Postprint version of: Nyström, M.E., Garvare, R., Westerlund, A., Weinehall, L. (2014). Concurrent Implementation of Quality Improvement Programs in Healthcare – Coordination or Conflict? International Journal of Health Care Quality Assurance, Vol 27, Issue 3 Concurrent Implementation of Quality Improvement Programmes: Coordination or Conflict? Author 1: Monica E. Nyström, PhD, Senior Lecturer in Organizational Psychology, Department of Learning, Informatics, Management and Ethics, Medical Management Centre and Department of Public Health and Clinical Medicine, Epidemiology and Global Health, University/Institution: Karolinska Institutet, Stockholm and Umeå University, Umeå, Sweden. Author 2: Rickard Garvare, PhD, Professor of Quality Management, Department of Business Administration, Technology and Social Sciences, University/Institution: Luleå University of Technology, Luleå, Sweden. Author 3: Anna Westerlund, MSc, Research Assistant, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, University/Institution: Umeå University, Umeå, Sweden. Author 4: Lars Weinehall, Professor of Epidemiology and Family Medicine, and Head of Department, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden. Corresponding author: Monica E. Nyström Corresponding Author’s Email: Monica.Nystrom@ki.se Acknowledgments (if applicable): The authors thank: (i) study participants and county council staff for sharing information and experiences; and (ii) Ms Elisabet Höög at the Department of LIME, Karolinska Institutet, for assisting with data collection and initial analyses. This work was financed by the Vinnvård research program in Sweden [Grant no A2007034], with contributions from the Strategic Research Programme in Care Sciences, funded by the Swedish Research Council and the FAS centre for Global Health at the Department of Public Health and Clinical Medicine, Umeå University. Structured Abstract Purpose - Competing activities and projects can interfere with implementing new knowledge and approaches. The purpose, therefore, was to investigate processes and impact related to implementing two concurrent quality initiatives in a Swedish hospital. These were a regionally initiated, system-wide organizational learning programme called the Dynamic and Viable Organization (DVO) and a national initiative on stopping healthcare-associated and hospital-acquired infections (SHAI). Both undertakings aspired to increase staff competence in systematic improvement approaches. Design/Methodology/Approach - Multiple methods were applied including surveys, observations, interviews, process diaries, documents and organizational measurements. Respondents were unit managers, change facilitators and improvement team members. Findings - Even though both initiatives shared the same improvement approach, there was no strong indication that they were strategically combined to benefit each other. The initiatives existed side-by side with some coordination and some conflict. Despite absent management strategies to utilize the national SHAI initiative, positive developments in QI culture and communication were reported. The current study illustrates the inherent difficulties coordinating change initiatives, even in favourable circumstances.