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Rungan S, Liu HM, Smith-Merry J, Eastwood J. Kalgal Burnbona: An Integrated Model of Care Between the Health and Education Sector. Int J Integr Care 2024; 24:14. [PMID: 38706536 PMCID: PMC11067974 DOI: 10.5334/ijic.7745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/17/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Kalgal Burnbona is a framework developed for applying school-based integrated care (SBIC) across Sydney Local Health District (SLHD). Description Kalgal Burnbona is an innovative and integrative framework developed to provide holistic, integrated, multidisciplinary child and family centred care to school-aged children from priority populations within SLHD, such as those belonging to the Aboriginal community. The expected outcomes include improved health, behavioural, education and social outcomes. This article contextualises the development of the Kalgal Burnbona framework from its beginnings as a pilot site called Ngaramadhi Space (NS) within the Healthy Homes and Neighbourhoods (HHAN) initiative, through to its evolution to an integrated partnership between the New South Wales (NSW) health and education sector. An example of how the framework can be implemented in other settings within SLHD is described. Discussion A tiered approach to integrated care across SLHD is postulated based on evidence from a mixed methods evaluation of NS and in line with the Rainbow Model of Integrated Care (RMIC). Kalgal Burnbona is an example of a community-driven response through collaborative partnerships to improve health, education and social outcomes. The framework described provides structure for multisector teams to work within, recognising that each community and school has its own history and needs. Conclusion The Kalgal Burnbona model can be scaled up to serve a wider network of students across SLHD. The initial successes of the model, which include improving access and engagement for children with unmet physical health, mental health and social needs while being accepted by communities provide evidence for policy changes and advocacy that centre on collaborative cross-sector partnerships.
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Affiliation(s)
- Santuri Rungan
- Croydon Health Centre, 24 Liverpool Road, Croydon, NSW, 2132, Australia
| | - Huei Ming Liu
- Menzies Centre for Health Policy, University of Sydney, Australia
- The George Institute for Global Health, University of New South Wales, Australia
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy (CDRP), Susan Wakil Health Building (D18), Camperdown Campus, The University of Sydney, NSW, 2006, Australia
| | - John Eastwood
- School of Population Health, University of New South Wales, Kensington, NSW, 2050, Australia
- Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
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Rungan S, Smith-Merry J, Liu HM, Drinkwater A, Eastwood J. School-Based Integrated Care Within Sydney Local Health District: A Qualitative Study About Partnerships Between the Education and Health Sectors. Int J Integr Care 2024; 24:13. [PMID: 38706539 PMCID: PMC11067993 DOI: 10.5334/ijic.7743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/17/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction The unmet physical and mental health needs of school-aged children (5-18 years) in New South Wales (NSW), stemming from poor access and engagement with healthcare, can be addressed by school-based integrated care (SBIC) models.This research aims to understand why and how partnerships between the health and education sector, in SBIC models, are important in providing care for children, and to identify the facilitating factors and barriers for implementation. Methods A qualitative study was conducted using semi-structured interviews and thematic analysis. The principles of the 'Integrated People-Centred Health Service (IPCHS)' framework and Looman et al's (2021) implementation strategies for integrated care were considered. Results Themes within IPCHS framework: Strategy 1: Engaging and empowering people and communities - community-driven models, improved access to healthcare, positive outcomes for children and families, 'connection', and service provision for marginalised populations; Strategy 2: Strengthening governance and accountability - system integration and developing evidence base; Strategy 3: Reorienting the model of care - shifting healthcare to schools reduces inequity and provides culturally safe practice; Strategy 4: Coordinating services within and across sectors - integrating care and stable workforce; Strategy 5: Creating an enabling environment: leadership, stakeholder commitment, and adequate resourcing. Discussion Potential strategies for implementing SBIC models across NSW include community consultation and co-design; building multidisciplinary teams with new competencies and roles e.g. linkers and coordinators; collaborative and shared leadership; and alignment of operational systems while maintaining a balance between structure and flexibility. Conclusion SBIC models require high-level collaboration across sectors and with communities to provide a shift towards child and family centred care that improves engagement, access and outcomes in health delivery.
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Affiliation(s)
- Santuri Rungan
- Croydon Health Centre, 24 Liverpool Road, Croydon, NSW, AU
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy (CDRP), Susan Wakil Health Building (D18), Camperdown Campus, The University of Sydney, NSW, 2006, AU
| | - Huei Ming Liu
- Menzies Centre for Health Policy, University of Sydney, AU
- The George Institute for Global Health, University of New South Wales, AU
| | - Alison Drinkwater
- Centre for Disability Research and Policy (CDRP), Susan Wakil Health Building (D18), Camperdown Campus, The University of Sydney, NSW, 2006, AU
| | - John Eastwood
- School of Population Health, University of New South Wales, Kensington, NSW 2050, AU
- Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown NSW 2050, AU
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Capobianco AML, Gallucci G, Lapadula L, Dinardo G, La Torre G, Sisti N, Sisti LG. Impact of the Multidisciplinary Cancer Team on the Diagnostic and Therapeutic Care Pathway of Early Breast Cancer Patients and Perception of Team Members: The Experience of a Cancer Centre in Italy. Cancer Invest 2024; 42:12-20. [PMID: 38149612 DOI: 10.1080/07357907.2023.2300442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/26/2023] [Indexed: 12/28/2023]
Abstract
Literature on the role of multidisciplinary team (MDT) in cancer is still controversial. We aimed to investigate MDT impact on a panel of indicators in breast cancer care in a single-center retrospective study performed in a Cancer Reference Center in Italy. We analysed the diagnostic and therapeutic care pathway (DTCP) of 266 early breast cancer patients managed by our MDT during 2019-2020. Process indicators reflecting the change of the diagnostic and therapeutic care pathways occurred after the MDT discussion were computed. Further, the performance of some quality care indicators in breast cancer care since the establishment of the MDT activity and the breast cancer MDT members' perceptions were also investigated. According to our study, the MDT approach improves breast cancer management by increasing the completion of staging and by encouraging neo-adjuvant treatment and an appropriate and faster surgery. In MDT members' perspective it also improves decision-making and training and creates a positive work environment. Globally, our study encourages MDT rollout in breast cancer care. However, to enhance the reliability and comparability of the results of studies investigating MDT effectiveness in clinical practice, shared guidelines on its operationalisation are strongly desirable.
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Affiliation(s)
- A M L Capobianco
- Multidisciplinary Oncology Unit, IRCCS CROB, Rionero in Vulture, Italy
| | - G Gallucci
- Cardio-oncology Unit, IRCCS CROB, Rionero in Vulture, Italy
| | - L Lapadula
- Radiotherapy Unit, IRCCS CROB, Rionero in Vulture, Italy
| | - G Dinardo
- Breast Radiology Unit, IRCCS CROB, Rionero in Vulture, Italy
| | - G La Torre
- Breast Surgery Unit, IRCCS CROB, Rionero in Vulture, Italy
| | - N Sisti
- Pharmacist and Pharmacovigilance Expert, Rome, Italy
| | - L G Sisti
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Rome, Italy
- International Relations, Relation with Regions and Project Cycle Management Unit - National Institute for Health, Migration and Poverty (INMP), Rome, Italy
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Braam A, Buljac-Samardzic M, Hilders CGJM, van Wijngaarden JDH. Collaboration Between Physicians from Different Medical Specialties in Hospital Settings: A Systematic Review. J Multidiscip Healthc 2022; 15:2277-2300. [PMID: 36237842 PMCID: PMC9552793 DOI: 10.2147/jmdh.s376927] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/02/2022] [Indexed: 11/06/2022] Open
Abstract
Health care today is characterized by an increasing number of patients with comorbidities for whom interphysician collaboration seems very important. We reviewed the literature to understand what factors affect interphysician collaboration, determine how interphysician collaboration is measured, and determine its effects. We systematically searched six major databases. Based on 63 articles, we identified five categories that influence interphysician collaboration: personal factors, professional factors, preconditions and tools, organizational elements, and contextual characteristics. We identified a diverse set of mostly unvalidated tools for measuring interphysician collaboration that focus on information being transferred and understood, frequency of interaction and tone of the relationship, and value judgements about quality or satisfaction. We found that interphysician collaboration increased clinical outcomes as well as patient and staff satisfaction, while error rates and length of stay were reduced. The results should, however, be interpreted with caution, as most of the studies provide a low level of evidence.
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Affiliation(s)
- Anoek Braam
- Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands,Correspondence: Anoek Braam, Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle Building, P.O. Box 1738, Rotterdam, DR 3000, the Netherlands, Email
| | - Martina Buljac-Samardzic
- Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Carina G J M Hilders
- Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jeroen D H van Wijngaarden
- Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Hospital physicians' experiences and reflections on their work and role in relation to older patients' pathways - a qualitative study in two Norwegian hospitals. BMC Health Serv Res 2022; 22:443. [PMID: 35382820 PMCID: PMC8981867 DOI: 10.1186/s12913-022-07846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background Older patients are the most frequent users of initial hospital admissions and readmissions. Both hospital admission and discharge require communication and coordination between healthcare professionals within the hospital, and between professionals in hospitals and primary healthcare. We have identified few studies exploring hospital physicians’ perspectives on older patients’ pathways in the interface between hospital and primary healthcare services. The aim of this study was to explore hospital physicians’ experiences and reflections on their work and role in relation to older patients’ pathways between hospital and primary healthcare. Specifically, we focused on the challenges they faced and how they dealt with these in relation to admission and discharge, and their suggestions for service improvements that could facilitate older patients’ pathway. Methods We used a qualitative approach, conducting individual in-depth interviews with 18 hospital physicians from two hospitals in eastern Norway. Data were analyzed using systematic text condensation, in line with a four-step prosedure developed by Malterud. Results The participants emphasized challenges in the communication about patients across the two service levels. Moreover, they described being in a squeeze between prioritizing patients and trying to ensure a proper flow of patients through the hospital wards, but with restricted possibilities to influence on the admissions. They also described a frustration regarding the lack of influence on the healthcare delivery after discharge. The participants had various suggestions for service improvements which might be beneficial to older patients. Conclusions The results demonstrate that the hospital physicians perceived being squeezed between professional autonomy and limited capacity at the hospital, and between their medical judgement as a specialist and their power to decide on hospital admissions for old patients and also on the delivery of health care services to patients after discharge. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07846-1.
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Ito-Masui A, Kawamoto E, Esumi R, Imai H, Shimaoka M. Sociometric wearable devices for studying human behavior in corporate and healthcare workplaces. Biotechniques 2021; 71:392-399. [PMID: 34164992 DOI: 10.2144/btn-2020-0160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Wearable sensor technology enables objective data collection of direct human interactions. The authors review sociometric wearable devices (SWD) and their application in healthcare. Human interactions captured by wearable sensors have been shown to correlate with social constructs such as teamwork and productivity in the office. Application of SWD in the field of healthcare requires special considerations: validation studies have shown technological disadvantages in acute medical settings. Application of SWD in healthcare should be considered based on the strengths and weaknesses of the methodology. SWD can also play an important role in investigation of human interaction and epidemic spread. When study designs and methodologies are carefully considered, incorporation of SWD in healthcare research has promising potential for new insights.
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Affiliation(s)
- Asami Ito-Masui
- Emergency & Critical Care Center, Mie University Hospital, Mie, 5148507, Japan.,Department of Emergency & Disaster Medicine, Mie University Graduate School of Medicine, Mie, 5148507, Japan.,Department of Molecular Pathobiology & Cell Adhesion Biology, Mie University Graduate School of Medicine, Mie, 5148507, Japan
| | - Eiji Kawamoto
- Emergency & Critical Care Center, Mie University Hospital, Mie, 5148507, Japan.,Department of Emergency & Disaster Medicine, Mie University Graduate School of Medicine, Mie, 5148507, Japan.,Department of Molecular Pathobiology & Cell Adhesion Biology, Mie University Graduate School of Medicine, Mie, 5148507, Japan
| | - Ryo Esumi
- Emergency & Critical Care Center, Mie University Hospital, Mie, 5148507, Japan.,Department of Emergency & Disaster Medicine, Mie University Graduate School of Medicine, Mie, 5148507, Japan.,Department of Molecular Pathobiology & Cell Adhesion Biology, Mie University Graduate School of Medicine, Mie, 5148507, Japan
| | - Hiroshi Imai
- Emergency & Critical Care Center, Mie University Hospital, Mie, 5148507, Japan.,Department of Emergency & Disaster Medicine, Mie University Graduate School of Medicine, Mie, 5148507, Japan
| | - Motomu Shimaoka
- Department of Molecular Pathobiology & Cell Adhesion Biology, Mie University Graduate School of Medicine, Mie, 5148507, Japan
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Chen J, Wang Y. Social Media Use for Health Purposes: Systematic Review. J Med Internet Res 2021; 23:e17917. [PMID: 33978589 PMCID: PMC8156131 DOI: 10.2196/17917] [Citation(s) in RCA: 203] [Impact Index Per Article: 67.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/29/2021] [Accepted: 04/11/2021] [Indexed: 12/23/2022] Open
Abstract
Background Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years. Objective This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies. Methods The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles. Results This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public. Conclusions Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns.
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Affiliation(s)
- Junhan Chen
- Department of Communication, University of Maryland, College Park, MD, United States
| | - Yuan Wang
- Department of Communication, University of Maryland, College Park, MD, United States
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Farsi D. Social Media and Health Care, Part I: Literature Review of Social Media Use by Health Care Providers. J Med Internet Res 2021; 23:e23205. [PMID: 33664014 PMCID: PMC8056296 DOI: 10.2196/23205] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/05/2020] [Accepted: 03/04/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND As the world continues to advance technologically, social media (SM) is becoming an essential part of billions of people's lives worldwide and is affecting almost every industry imaginable. As the world is becoming more digitally oriented, the health care industry is increasingly visualizing SM as an important channel for health care promotion, employment, recruiting new patients, marketing for health care providers (HCPs), building a better brand name, etc. HCPs are bound to ethical principles toward their colleagues, patients, and the public in the digital world as much as in the real world. OBJECTIVE This review aims to shed light on SM use worldwide and to discuss how it has been used as an essential tool in the health care industry from the perspective of HCPs. METHODS A literature review was conducted between March and April 2020 using MEDLINE, PubMed, Google Scholar, and Web of Science for all English-language medical studies that were published since 2007 and discussed SM use in any form for health care. Studies that were not in English, whose full text was not accessible, or that investigated patients' perspectives were excluded from this part, as were reviews pertaining to ethical and legal considerations in SM use. RESULTS The initial search yielded 83 studies. More studies were included from article references, and a total of 158 studies were reviewed. SM uses were best categorized as health promotion, career development or practice promotion, recruitment, professional networking or destressing, medical education, telemedicine, scientific research, influencing health behavior, and public health care issues. CONCLUSIONS Multidimensional health care, including the pairing of health care with SM and other forms of communication, has been shown to be very successful. Striking the right balance between digital and traditional health care is important.
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Affiliation(s)
- Deema Farsi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Berardi R, Morgese F, Rinaldi S, Torniai M, Mentrasti G, Scortichini L, Giampieri R. Benefits and Limitations of a Multidisciplinary Approach in Cancer Patient Management. Cancer Manag Res 2020; 12:9363-9374. [PMID: 33061625 PMCID: PMC7533227 DOI: 10.2147/cmar.s220976] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 05/26/2020] [Indexed: 12/17/2022] Open
Abstract
Over the years, a growing body of literature has confirmed as beneficial the implementation of a multidisciplinary approach in the so-often-intricate scenario of cancer patients' management. Together with the consolidation of tumor-board experience in clinical practice, certain aspects have emerged as controversial and a source of current debate. In this systematic literature review, we focused our attention on the impact of multidisciplinary tumor boards, assessing benefits and limitations as a result of the dissemination of such approaches. On the bright side, adherence to clinical guidelines, treatment outcomes, and overall improvement in decision-making processes have been recognized as advantages. On the other side, our analysis highlights a few limitations that should be taken into account to optimize cancer patients' management. Of note, some issues, such as costs, legal responsibility, geographic barriers, and treatment delays, have yet to be resolved. In order partly to address this matter, software platforms and novel methods of computational analysis may provide the needed support. Therefore, the aim of our analysis was to describe the multidisciplinary approach in cancer care in terms of adherence to clinical guidelines, treatment outcomes, and overall improvement in decision-making processes through a systematic review of the literature.
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Affiliation(s)
- Rossana Berardi
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Francesca Morgese
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Silvia Rinaldi
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Mariangela Torniai
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Giulia Mentrasti
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Laura Scortichini
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - Riccardo Giampieri
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
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