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Færk G, Søndergaard E, Skov L, Thyssen JP, Hansen KS, Reventlow S. Parents of children with atopic diseases - experiences with care and the interaction with healthcare professionals over time. Scand J Prim Health Care 2024:1-10. [PMID: 38829768 DOI: 10.1080/02813432.2024.2357794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE To explore how the parents of children with atopic dermatitis and allergic diseases such as food allergy, allergic rhinoconjunctivitis, and asthma experience interactions with the Danish healthcare system over time. DESIGN AND METHODS A qualitative design with individual in-depth interviews. The analysis was inspired by Systematic Text Condensation. SUBJECTS Eleven parents of children with atopic dermatitis and allergic diseases who received treatment at hospitals in the Capital Region of Denmark. The families had experiences of cross-sectoral patient care. RESULTS Despite having the same diseases, the children's care pathways were very different. Mapping demonstrated the intricacy of care pathways for this group of children. We identified three aspects that impacted interaction with healthcare: responsibility, tasks, and roles. The families experienced care when the distribution of tasks and responsibilities associated with treatment and system navigation were consistent with both their expectations and their actual experiences. At the same time, families frequently experienced limited collaboration between healthcare professionals resulting in perceived fragmented care and an extended role for parents as care coordinators. Families felt cared for when healthcare professionals knew both their biomedical and biographical circumstances, and adjusted the level of support and care in accordance with the families' particular needs, expectations, and evolving competences. CONCLUSION We suggest that a possible pathway to improve care may be through a partnership approach as part of family-centered care, with general practitioners having a key role in helping to articulate the individual needs and expectations of each family.
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Affiliation(s)
- Gitte Færk
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Centre for General Practice, The Research Unit for General Practice Slagelse/Copenhagen, and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Allergy Research Center, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Elisabeth Søndergaard
- Centre for General Practice, The Research Unit for General Practice Slagelse/Copenhagen, and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Pontoppidan Thyssen
- Department of Dermatology and Venereology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kirsten Skamstrup Hansen
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Pediatrics, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Susanne Reventlow
- Centre for General Practice, The Research Unit for General Practice Slagelse/Copenhagen, and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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van der Schors W, Roos AF, Kemp R, Varkevisser M. Reasons for merging and collaborating in healthcare: Marriage or living apart together? Int J Health Plann Manage 2023; 38:1721-1742. [PMID: 37544018 DOI: 10.1002/hpm.3695] [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: 02/17/2022] [Revised: 02/01/2023] [Accepted: 07/16/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Across OECD countries, integration between healthcare organisations has become an indispensable part of contemporary healthcare provision. In recent years, inter-organisational collaboration has increasingly been encouraged in health and competition policy at the expense of mergers. Yet, understanding of whether healthcare organisations make an active choice between merging and collaborating is lacking. Hence, this study systematically examines (i) healthcare executives' motives for integration, (ii) their potential trade-offs between collaborating or merging, and (iii) the barriers to collaborating perceived by them. METHODS Early 2019, an online questionnaire was conducted among a nationwide panel of 714 healthcare executives in the Netherlands. Because of their strategic position within healthcare organisations as end-responsible managers, healthcare executives are especially suited to provide broad and in-depth knowledge on the internal and external processes and decisions. Three hundred thirty-seven Dutch healthcare executives completed the questionnaire (response rate 47%). This study sample was representative of the largest healthcare sectors in the Netherlands. In total, 137 mergers and 235 inter-organisational collaborations were reported. Both closed questions and open-ended questions were systematically analysed. RESULTS Improving or broadening healthcare provision is the foremost motive for mergers as well as inter-organisational collaborations. When considering both types, reducing governance complexity is one of the decisive reasons to opt for a merger, whereas aversion towards a full merger and lack of support base within the own organisation convinced healthcare executives to choose for a collaboration. When comparing specific healthcare sectors, the overlap in pursued motives and sub-motives indicates that inter-organisational collaborations and mergers are used for comparable objectives. Only a small minority of the responding executives switched between both types of integration. Institutional barriers, such as laws, regulations and financing regimes, appear to be the most restricting for healthcare executives to engage in inter-organisational collaborations. CONCLUSIONS Our integral approach and systematic comparison across sectors could serve policymakers, regulators and healthcare providers in aligning organisational objectives and societal objectives in decision-making on collaborations and mergers. Future research is recommended to study multiple collaboration and merger cases qualitatively for a detailed examination of decision-making by healthcare executives, and develop an integral assessment framework for balancing collaborations and mergers based on their effects in the medium to long term.
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Affiliation(s)
- Wouter van der Schors
- Erasmus University Rotterdam, Rotterdam, The Netherlands
- Dutch Health and Youth Care Inspectorate, Utrecht, The Netherlands
| | - Anne-Fleur Roos
- Erasmus University Rotterdam, Rotterdam, The Netherlands
- Netherlands Bureau for Economic Policy Analysis, The Hague, The Netherlands
| | - Ron Kemp
- Erasmus University Rotterdam, Rotterdam, The Netherlands
- Netherlands Authority for Consumers and Markets, The Hague, The Netherlands
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Petersen JJ, Østergaard B, Svavarsdóttir EK, Palonen M, Brødsgaard A. Hospital and homecare nurses' experiences of involvement of patients and families in transition between hospital and municipalities: A qualitative study. Scand J Caring Sci 2023; 37:196-206. [PMID: 36349680 DOI: 10.1111/scs.13130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 09/08/2022] [Accepted: 10/15/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Involving patients and families in nursing care is essential to improve patients' health outcomes. Furthermore, families play an essential role in supporting patients by helping nurses understand the patient's everyday life. However, families also need support. Involvement of patients and families is especially important when patients are transferred between hospital and home as transitions heighten the risk of compromising quality and safety in care. However, no consensus exists on how to involve them. Consequently, this may challenge a systematic approach toward patient and family involvement. AIM To describe hospital and homecare nurses' experiences with involving patients and their family members in nursing care in the transition between hospital and municipalities. METHOD Focus group interviews were conducted in the Gastro unit at a large university hospital in Denmark. Participants included 10 hospital nurses from three wards at the Gastro unit and six homecare nurses from one of three municipalities in the hospital catchment area (total n = 16). Data were analysed using qualitative content analysis. The study is reported according to the Consolidated Criteria for Reporting Qualitative Research. FINDINGS Our analysis revealed one overall theme - "The complexity of involvement" - based on four categories: gap between healthcare sectors increases the need for patient and family involvement, lack of time is a barrier to patient and family involvement, involvement is more than information, and involvement as a balancing act. CONCLUSION The nurses experienced patients' and families' involvement as essential, but a discrepancy was found between nurses' intentions and their actions. Aspects related to a gap between healthcare sectors and various understandings of involvement challenged the systematic involvement of patients and families in the transition between healthcare sectors. However, the nurses were highly motivated to achieve a close cross-sectoral collaboration and to show commitment towards patients and families.
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Affiliation(s)
- Julie Jacoby Petersen
- Department of Surgical Gastroenterology, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.,Section for Nursing, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Mira Palonen
- Faculty of Social Sciences, health sciences, Tampere University, Tampere, Finland
| | - Anne Brødsgaard
- Section for Nursing, Department of Public Health, University of Aarhus, Aarhus, Denmark.,Department of Paediatrics and Adolescent Medicin, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark
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Ravn MB, Berthelsen C, Maribo T, Nielsen CV, Pedersen CG, Handberg C. Understanding Facilitators and Challenges to Care Transition in Cardiac Rehabilitation: Perspectives and Assumptions of Healthcare Professionals. Glob Qual Nurs Res 2023; 10:23333936231217844. [PMID: 38107551 PMCID: PMC10722928 DOI: 10.1177/23333936231217844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023] Open
Abstract
Cardiac rehabilitation is an essential part of treatment for patients with cardiovascular disease. Cardiac rehabilitation is increasingly organized outside hospital in community healthcare services. However, this transition may be challenging. The aim of this study was to examine assumptions and perspectives among healthcare professionals on how facilitators and challenges influence the transition from hospital to community healthcare services for patients in cardiac rehabilitation. The study followed the Interpretive Description methodology and data consisted of participant observations and focus group interviews. The analysis showed that despite structured guidelines aimed to support the collaboration, improvements could be made. Facilitators and challenges could occur in the collaboration between the healthcare professionals, in the collaboration with the patient, or because of the new reality for patients when diagnosed with cardiovascular disease.
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Affiliation(s)
- Maiken Bay Ravn
- Aarhus University, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| | - Connie Berthelsen
- Zealand University Hospital, Køge and Roskilde, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Thomas Maribo
- Aarhus University, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| | - Claus Vinther Nielsen
- Aarhus University, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
- Region Hospital Goedstrup, Denmark
| | | | - Charlotte Handberg
- Aarhus University, Denmark
- National Rehabilitation Center for Neuromuscular Diseases; Aarhus, Denmark
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Persson MH, Søndergaard J, Mogensen CB, Skjøt-Arkil H, Andersen PT. Healthcare professionals' experiences and attitudes to care coordination across health sectors: an interview study. BMC Geriatr 2022; 22:509. [PMID: 35729544 PMCID: PMC9210644 DOI: 10.1186/s12877-022-03200-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background The number of older people is increasing, resulting in more people endure chronic diseases, multimorbidities and complex care needs. Insufficient care coordination across healthcare sectors has negative consequences for health outcomes, costs and patient evaluation. Despite introducing initiatives to solve coordination challenges within healthcare, the need remains for more consistent solutions. In particular, improved care coordination would benefit older adults characterised by complex care needs, high use of healthcare resources and multiple care providers. Aims and objectives To identify and analyse healthcare professionals’ perspectives and approaches to care coordination across sectors when older people are acutely hospitalised. Design Qualitative interview study. Methods Semi-structured, individual interviews with 13 healthcare professionals across health sectors and professions were conducted. The strategy for the qualitative analysis was inspired by Kirsti Malterud and labelled ‘systematic text condensation’. This strategy is a descriptive and explorative method for thematic cross-case analysis of qualitative data. Results Four themes/categories emerged from the analysis; “Organisational factors”, “Approaches to care”, “Communication and knowledge”, and “Relations”. Conclusion Different organisational cultures can discourage intersectoral care coordination. Approaches to care vary at all levels across health sectors and professions. Organisational, leadership and professional identity affect the working cultures and must be considered in the future recruitment and socialisation of healthcare staff. Our research suggests that combinations of healthcare standardisations and flexible, adaptive solutions are required to improve intersectoral care coordination. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03200-6.
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Affiliation(s)
- Maiken Hjuler Persson
- Department of Public Health, University of Southern Denmark, Degnevej 14, 6705, Esbjerg, Denmark.
| | - Jens Søndergaard
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, J. B. Winsløws Vej 9A, 5000, Odense, Denmark
| | - Christian Backer Mogensen
- Emergency Department, Hospital Sønderjylland, Kresten Philipsens vej 15, 6200, Aabenraa, Denmark.,Department of Regional Health Research, University of Southern, Winsløwparken 19,3, 5000, Odense, Denmark
| | - Helene Skjøt-Arkil
- Emergency Department, Hospital Sønderjylland, Kresten Philipsens vej 15, 6200, Aabenraa, Denmark.,Department of Regional Health Research, University of Southern, Winsløwparken 19,3, 5000, Odense, Denmark
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Barriers for Inter-Organisational Collaboration: What Matters for an Integrated Care Programme? Int J Integr Care 2022; 22:22. [PMID: 35756340 PMCID: PMC9205373 DOI: 10.5334/ijic.6005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 06/02/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Inter-organisational collaboration is challenging but essential in managing the complex and comprehensive needs of frail older people. Therefore, there is a need to investigate the influence of different barriers to inter-organisational collaboration when implementing an integrated care programme. The aim of this study was to investigate both inpatient and outpatient staff views on the factors they deemed to be influential to inter-organisational collaboration for an integrated care programme. Methods The study was a cross-sectional study and included staff from hospitals, primary care and municipal health and social care. Results There were no significant differences between staff from inpatient and outpatient care in measuring factors that may cause difficulties for inter-organisational collaboration. Staff views diverged significantly on all factors, such as educational level at long physical distances, laws and regulations, knowledge of each others work settings, experience from inter-organisational collaboration, different professions, variations in professional status and power, psychosocial factors such as positive work environment and interpersonal chemistry. Discussion A multidisciplinary team culture and avenues for inter-organisational collaboration need to be developed for improved care continuity. Conclusion The staffs' educational level influenced what was perceived as barriers to inter-organisational collaboration, and may guide future development of integrated care programmes.
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Simonÿ C, Neerup Andersen M, Hansen RG, Schrøder L, Jensen TG, Bodtger U, Birkelund R, Beck M. Shaping Better Rehabilitation to Chronic Obstructive Pulmonary Disease Patients: Experiences of Nurses and Colleagues With an Interdisciplinary Telerehabilitation Intervention. Glob Qual Nurs Res 2022; 9:23333936221109890. [PMID: 36046468 PMCID: PMC9421008 DOI: 10.1177/23333936221109890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/18/2022] [Accepted: 05/26/2022] [Indexed: 11/15/2022] Open
Abstract
In order to evaluate the reach of a collaborative cross-sectoral telerehabilitation intervention to patients with Chronic Obstructive Pulmonary Disease (COPD), this study investigates how nurses and interdisciplinary colleagues experienced working with it. In two focus group interviews, the experiences of working in the empowerment and tele-based >C☺PD-Life>> program were examined among three nurses and four interdisciplinary colleagues. Data were analyzed with inspiration from Ricoeur’s theory of narrative and interpretation and discussed with Gittell’s theory of relational coordination. Nurses and colleagues experienced that the intervention paved the way for unique patient-professional coordination and interdisciplinary cross-sectoral teamwork that allowed double-layered relational coordination, focusing holistically on patients’ lived challenges in everyday life with COPD. By this rehabilitation setup, nurses and colleagues are perceived as educated to deliver high standard personalized support, raising professional pride and confidence. The findings can inspire future health-promoting initiatives within nursing support related to patients afflicted with COPD.
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Affiliation(s)
- Charlotte Simonÿ
- University of Southern Denmark, Odense, Denmark.,Naestved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
| | | | | | | | | | - Uffe Bodtger
- University of Southern Denmark, Odense, Denmark.,Zealand University Hospital Næstved, Denmark.,Zealand University Hospital Roskilde, Denmark
| | - Regner Birkelund
- University of Southern Denmark, Odense, Denmark.,Vejle Sygehus, Denmark
| | - Malene Beck
- Naestved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark.,Aarhus University, Aarhus and Emdrup, Denmark
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8
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Workforce Development in Integrated Care: A Scoping Review. Int J Integr Care 2021; 21:23. [PMID: 34899102 PMCID: PMC8622255 DOI: 10.5334/ijic.6004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/04/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Integrated care aims to improve access, quality and continuity of services for ageing populations and people experiencing chronic conditions. However, the health and social care workforce is ill equipped to address complex patient care needs due to working and training in silos. This paper describes the extent and nature of the evidence on workforce development in integrated care to inform future research, policy and practice. Methods A scoping review was conducted to map the key concepts and available evidence related to workforce development in integrated care. Results Sixty-two published studies were included. Essential skills and competencies included enhancing workforce understanding across the health and social care systems, developing a deeper relationship with and empowering patients and their carers, understanding community needs, patient-centeredness, health promotion, disease prevention, interprofessional training and teamwork and being a role model. The paper also identified training models and barriers/challenges to workforce development in integrated care. Discussion and Conclusion Good-quality research on workforce development in integrated care is scarce. The literature overwhelmingly recognises that integrated care training and workforce development is required, and emerging frameworks and competencies have been developed. More knowledge is needed to implement and evaluate these frameworks, including the broader health and social care workforces within a global context. Further research needs to focus on the most effective methods for implementing these competencies.
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Persson MH, Mogensen CB, Søndergaard J, Skjøt-Arkil H, Andersen PT. Healthcare professionals' practice and interactions in older peoples' cross-sectoral clinical care trajectories when acutely hospitalized - a qualitative observation study. BMC Health Serv Res 2021; 21:944. [PMID: 34503461 PMCID: PMC8431887 DOI: 10.1186/s12913-021-06953-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare services have become more complex, globally and nationally. Denmark is renowned for an advanced and robust healthcare system, aiming at a less fragmented structure. However, challenges within the coordination of care remain. Comprehensive restructures based on marketization and efficiency, e.g. New Public Management (NPM) strategies has gained momentum in Denmark including. Simultaneously, changes to healthcare professionals' identities have affected the relationship between patients and healthcare professionals, and patient involvement in decision-making was acknowledged as a quality- and safety measure. An understanding of a less linear patient pathway can give rise to conflict in the care practice. Social scientists, including Jürgen Habermas, have highlighted the importance of communication, particularly when shared decision-making models were introduced. Healthcare professionals must simultaneously deliver highly effective services and practice person-centered care. Co-morbidities of older people further complicate healthcare professionals' practice. AIM This study aimed to explore and analyse how healthcare professionals' interactions and practice influence older peoples' clinical care trajectory when admitted to an emergency department (ED) and the challenges that emerged. METHODS This qualitative study arises from a hermeneutical stand within the interpretative paradigm. Focusing on the healthcare professionals' interactions and practice we followed the clinical care trajectories of seven older people (aged > 65, receiving daily homecare) acutely hospitalized to the ED. Participant observations were combined with interviews with healthcare professionals involved in the clinical care trajectory. We followed-up with the older person by phone call until four weeks after discharge. The study followed the code of conduct for research integrity and is reported in accordance with the Standards for Reporting Qualitative Research (SRQR) guidelines. RESULTS The analysis revealed four themes: 1)"The end justifies the means - 'I know what is best for you'", 2)"Basic needs of care overruled by system effectiveness", 3)"Treatment as a bargain", and 4)"Healthcare professionals as solo detectives". CONCLUSION Dissonance between system logics and the goal of person-centered care disturb the healthcare practice and service culture negatively affecting the clinical care trajectory. A practice culture embracing better communication and more person-centered care should be enhanced to improve the quality of care in cross-sectoral trajectories.
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Affiliation(s)
- Maiken Hjuler Persson
- Emergency Department, Hospital Sønderjylland, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark.
- Research Unit for Health Promotion, Department of Public Health, University of Southern Denmark, Degnevej 14, 6705, Esbjerg, Denmark.
| | - Christian Backer Mogensen
- Emergency Department, Hospital Sønderjylland, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark
- Department of Regional Health Research, Winsløwparken 19,3, 5000, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, J. B. Winsløws Vej 9A, 5000, Odense, Denmark
- Research Unit for Health Promotion, Department of Public Health, University of Southern Denmark, Degnevej 14, 6705, Esbjerg, Denmark
| | - Helene Skjøt-Arkil
- Emergency Department, Hospital Sønderjylland, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark
- Department of Regional Health Research, Winsløwparken 19,3, 5000, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Pernille Tanggaard Andersen
- Research Unit for Health Promotion, Department of Public Health, University of Southern Denmark, Degnevej 14, 6705, Esbjerg, Denmark
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Schlünsen ADM, Christiansen DH, Fredberg U, Vedsted P. Patient characteristics and healthcare utilisation among Danish patients with chronic conditions: a nationwide cohort study in general practice and hospitals. BMC Health Serv Res 2020; 20:976. [PMID: 33106173 PMCID: PMC7586660 DOI: 10.1186/s12913-020-05820-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 10/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background The complexity of caring for patients with chronic conditions necessitates new models of integrated care to accommodate an increasing demand. To inform the development of integrated care models, it is essential to map patients’ use of healthcare resources. In this nationwide registry-based cohort study, we describe and compare patient characteristics and healthcare utilisation between Danish patients with chronic conditions in general practice follow-up and in hospital outpatient follow-up. Methods On 1 January 2016, we identified 250,402 patients registered in 2006–2015 with a hospital diagnosis of atrial fibrillation/flutter, congestive heart failure, chronic liver disease, inflammatory bowel disease or chronic obstructive pulmonary disease. By linkage to national social and health registries, patient characteristics and 12-month healthcare utilisation were extracted. Incidence rates of health care utilisation were compared between patients with chronic conditions in general practice follow-up and patients in hospital outpatient follow-up using negative binomial regression. Results Across all five conditions, the largest proportions of patients were in general practice follow-up (range = 59–87%). Patients in hospital outpatient follow-up had higher rates of exacerbation-related admissions (adjusted incidence rate ratio (IRR) range = 1.3 to 2.8) and total length of stay (IRR range = 1.2 to 2.2). For these five conditions, all-cause admissions and lengths of stay, general practice daytime and out-of-hours contacts, and municipal home nursing contacts were similar between follow-up groups or higher among patients in general practice follow-up. The exception was patients with chronic obstructive pulmonary disease, where patients in hospital outpatient follow-up had higher utilisation of healthcare resources. Conclusions Patients in general practice follow-up accounted for the largest proportion of total healthcare utilisation, but patients in hospital outpatient follow-up were characterised by high exacerbation rates. Enhanced integration of chronic care may be of most benefit if patients in general practice follow-up are targeted, but it is also likely to have an impact on exacerbation rates among patients in hospital outpatient follow-up.
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Affiliation(s)
- Anders Damgaard Møller Schlünsen
- Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Department of Clinical Medicine, Silkeborg Regional Hospital, Aarhus University, Silkeborg, Denmark.
| | - David Høyrup Christiansen
- Department of Occupational Medicine, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark.,Department of Clinical Medicine, HEALTH, Aarhus University, Aarhus, Denmark
| | - Ulrich Fredberg
- Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Department of Clinical Medicine, Silkeborg Regional Hospital, Aarhus University, Silkeborg, Denmark
| | - Peter Vedsted
- Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Department of Clinical Medicine, Silkeborg Regional Hospital, Aarhus University, Silkeborg, Denmark.,Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, Denmark
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What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care. Int J Integr Care 2020; 20:8. [PMID: 32874167 PMCID: PMC7442175 DOI: 10.5334/ijic.5419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction: To provide integrated Youth Care responsive to the needs of families with multiple problems across life domains, it is essential to incorporate parental perspectives into clinical practice. The aim of this study is to advance our understanding of key components of integrated Youth Care from a parental perspective. Methods: Semi-structured interviews were administered to 21 parents of children receiving Youth Care from integrated care teams in the Netherlands. Qualitative content analysis was conducted by means of a grounded theory approach following qualitative reporting guidelines. Results and discussion: Parental perspectives were clustered into six key components: a holistic, family-centred approach; addressing a broad range of needs in a timely manner; shared decision making; interprofessional collaboration; referral; and privacy. Parents emphasized the importance of a tailored, family-centred approach, addressing needs across several life domains, and active participation in their own care process. However, they simultaneously had somewhat opposing expectations regarding these key components, for example, concerning the changing roles of professionals and parents in shared decision making and the value of involving family members in a care process. Professionals should be aware of these opposing expectations by explicitly discussing mutual expectations and changing roles in decision making during a care process. To enable parents to make their own decisions, professionals should transparently propose different options for support guided by an up-to-date care plan.
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Leadership in Integrated Care Networks: A Literature Review and Opportunities for Future Research. Int J Integr Care 2020; 20:6. [PMID: 32863804 PMCID: PMC7427680 DOI: 10.5334/ijic.5420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction In many countries, elderly patients with chronic conditions require a web of services delivered by several providers collaborating in inter-organisational networks. In view of their global importance, it is surprising how little we know how these networks are led. Like traditional organisations, networks require leadership to function effectively. This paper reviews central characteristics of leadership in integrated care networks and proposes opportunities for future research. Theory and methods Analysing 73 studies published in leading academic journals, this paper consolidates research on leadership media, practices, activities and outcomes, covering the network, policy and organisation levels of analysis. Results Findings indicate that the field has focused on leadership media and outcomes at the network level. They also suggest that leadership in integrated care networks faces multiple tensions. Future research could usefully provide a fuller picture by examining leadership practices, activities and outcomes at the policy and organisation level, integrating advances in the wider leadership literature. Discussion and conclusion These findings contribute to the debate on leadership in integrated care networks. They also inform practice, drawing attention to persistent tensions as a core leadership challenge and offering latest scholarly evidence practitioners can use to reflect on and advance their own leadership practice.
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Varley J, Kiersey R, Power R, Byrne JP, Doherty C, Saris J, Lambert V, Fitzsimons M. Igniting intersectoral collaboration in chronic disease management: a participatory action research study on epilepsy care in Ireland. J Interprof Care 2019; 34:500-508. [PMID: 31851541 DOI: 10.1080/13561820.2019.1697655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Models of care developed to improve the lives of people with chronic diseases highlight integrated care as essential to meeting their needs and achieving person (patient)-centered care (PCC). Nevertheless, barriers to collaborative practice and siloed work environments persist. To set in motion some groundwork for intersectoral collaboration this study brought two expert groups of epilepsy care practitioners together to engage in participatory action research (PAR). The expert practitioner groups were hospital-based epilepsy specialist nurses (ESNs) and community-based resource officers (CROs). The PAR highlighted, that while the participants share a mutual interest in caring for people with epilepsy, underdeveloped CRO-ESN relationships, arising from unconscious bias and ambiguity can result in missed opportunities for optimal care coordination with consequent potential for unnecessary replication and waste of finite resources. However, through dialogue and critical self-reflection, a growing emotional connection between the disciplines evolved over the course of the PAR. This allowed for buds of collaboration to develop with CROs and ESNs working together to tackle some of the key barriers to their collaboration.
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Affiliation(s)
- Jarlath Varley
- Research and Innovation, The Royal College of Surgeons in Ireland , Dublin 2, Ireland
| | - Rachel Kiersey
- Research and Innovation, The Royal College of Surgeons in Ireland , Dublin 2, Ireland
| | - Robert Power
- Research and Innovation, The Royal College of Surgeons in Ireland , Dublin 2, Ireland
| | - John-Paul Byrne
- Department of Anthropology, National University of Ireland (NUI) Maynooth , Ireland
| | - Colin Doherty
- Department of Neurology, St. James's Hospital , Dublin 8, Ireland.,School of Medicine, Trinity College , Dublin 2, Ireland.,FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland , Dublin, Ireland
| | - Jamie Saris
- Department of Anthropology, National University of Ireland (NUI) Maynooth , Ireland
| | - Veronica Lambert
- School of Nursing, Psychotherapy and Community Health, Dublin City University , Dublin 9, Ireland
| | - Mary Fitzsimons
- FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland , Dublin, Ireland
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Mohiuddin AK. The New Era of Pharmacists in Ambulatory Patient Care. Innov Pharm 2019; 10:10.24926/iip.v10i1.1622. [PMID: 34007527 PMCID: PMC7643699 DOI: 10.24926/iip.v10i1.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pharmacy is evolving from a product-oriented to a patient-oriented profession. This role modification is extremely healthy for the patient, the pharmacist, and other members of the health-care team. However, the evolution will present pharmacists with a number of new challenges. Now, more than in the past, pharmacists must make the acquisition of contemporary practice knowledge and skills a high priority, to render the level of service embodied in the concept of pharmaceutical care. Pharmacy educators' organizations and regulatory bodies must all work together to support pharmacists as they assume expanded health-care roles. Pharmacy and the healthcare industry must work to ensure that the pharmacist is compensated justly for all services. But before this can happen it will be necessary for pharmacy to demonstrate value-added to the cost of the prescription. Marketing of the purpose of pharmacy in the health-care morass and of the services provided by the pharmacist is needed to generate an appropriate perceived value among purchasers and users of health-care services. Pharmacists should view themselves as dispensers of therapy and drug effect interpretations as well as of drugs themselves. Service components of pharmacy should be identified clearly to third party payers and be visible to consumers, so that they know what is available at what cost and how it may be accessed. In the future, pharmacy services must be evaluated on patient outcome (i.e., pharmaceutical care) rather than the number of prescriptions dispensed, and pharmacy must evolve toward interpretation and patient consultation, related to the use of medication technologies.
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Affiliation(s)
- AK Mohiuddin
- Department of Pharmacy, World University of Bangladesh
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Karlsson M, Garvare R, Zingmark K, Nordström B. Organizing for sustainable inter-organizational collaboration in health care processes. J Interprof Care 2019; 34:241-250. [PMID: 31329471 DOI: 10.1080/13561820.2019.1638760] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Integrating health care services has proven to be important from both the patient and organizational perspectives. This study explores what defines a perceived well-functioning collaboration in the inter-organizational process of providing assistive devices in Sweden. Two focus groups comprising participants with profound knowledge of collaboration were performed, and data were analyzed in five steps, resulting in a data structure. Results yield the identification of three interacting processes: coordinating efforts to patient needs, ensuring evidence-based practice, and planning for efficient use of resources. These processes affected one another, and, therefore, would likely not have been effectively managed separately. The study contributes to theories of process management and organization by specifically focusing on how to analyze and improve sustainable collaboration in health care processes at both the management and professional levels. Theoretical frameworks that show different ways of organizing collaboration, as well as the concepts of action nets and boundary objects, can support both analysis and planning of collaboration. The intention would be to develop integration in inter-organizational health care processes, resulting in more person-centered care.
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Affiliation(s)
- Margareta Karlsson
- Department of Business Administration, Technology and Social Sciences, Luleå University of Technology, Luleå, Sweden
| | - Rickard Garvare
- Department of Business Administration, Technology and Social Sciences, Luleå University of Technology, Luleå, Sweden
| | - Karin Zingmark
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Birgitta Nordström
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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Baxter S, Johnson M, Chambers D, Sutton A, Goyder E, Booth A. Understanding new models of integrated care in developed countries: a systematic review. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06290] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BackgroundThe NHS has been challenged to adopt new integrated models of service delivery that are tailored to local populations. Evidence from the international literature is needed to support the development and implementation of these new models of care.ObjectivesThe study aimed to carry out a systematic review of international evidence to enhance understanding of the mechanisms whereby new models of service delivery have an impact on health-care outcomes.DesignThe study combined rigorous and systematic methods for identification of literature, together with innovative methods for synthesis and presentation of findings.SettingAny setting.ParticipantsPatients receiving a health-care service and/or staff delivering services.InterventionsChanges to service delivery that increase integration and co-ordination of health and health-related services.Main outcome measuresOutcomes related to the delivery of services, including the views and perceptions of patients/service users and staff.Study designEmpirical work of a quantitative or qualitative design.Data sourcesWe searched electronic databases (between October 2016 and March 2017) for research published from 2006 onwards in databases including MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Science Citation Index, Social Science Citation Index and The Cochrane Library. We also searched relevant websites, screened reference lists and citation searched on a previous review.Review methodsThe identified evidence was synthesised in three ways. First, data from included studies were used to develop an evidence-based logic model, and a narrative summary reports the elements of the pathway. Second, we examined the strength of evidence underpinning reported outcomes and impacts using a comparative four-item rating system. Third, we developed an applicability framework to further scrutinise and characterise the evidence.ResultsWe included 267 studies in the review. The findings detail the complex pathway from new models to impacts, with evidence regarding elements of new models of integrated care, targets for change, process change, influencing factors, service-level outcomes and system-wide impacts. A number of positive outcomes were reported in the literature, with stronger evidence of perceived increased patient satisfaction and improved quality of care and access to care. There was stronger UK-only evidence of reduced outpatient appointments and waiting times. Evidence was inconsistent regarding other outcomes and system-wide impacts such as levels of activity and costs. There was an indication that new models have particular potential with patients who have complex needs.LimitationsDefining new models of integrated care is challenging, and there is the potential that our study excluded potentially relevant literature. The review was extensive, with diverse study populations and interventions that precluded the statistical summary of effectiveness.ConclusionsThere is stronger evidence that new models of integrated care may enhance patient satisfaction and perceived quality and increase access; however, the evidence regarding other outcomes is unclear. The study recommends factors to be considered during the implementation of new models.Future workLinks between elements of new models and outcomes require further study, together with research in a wider variety of populations.Study registrationThis study is registered as PROSPERO CRD37725.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Susan Baxter
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Maxine Johnson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Anthea Sutton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Raus K, Mortier E, Eeckloo K. Organizing Health Care Networks: Balancing Markets, Government and Civil Society. Int J Integr Care 2018; 18:6. [PMID: 30093844 PMCID: PMC6078116 DOI: 10.5334/ijic.3960] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 07/03/2018] [Indexed: 11/20/2022] Open
Abstract
Much is changing in health care organization today. A perspective or paradigm that is gaining ever increasing momentum is that of translational, extramural and integrated care. Current research suggests many potential benefits for integrated care and health care networks but the ethical issues are less frequently emphasized. Showing that integrated care can be beneficial, does not mean it is automatically ethically justified. We will argue for three ethical requirements such health care networks should meet. Subsequently we will look at the mechanisms driving the formation of networks and examine how these can cause networks to meet or fail to meet these ethical requirements or obligations. The three mechanisms we will examine are government, civil society and market mechanisms, which, we argue, should be balanced properly. Each mechanism is able to provide a relevant ethical perspective to health care networks. However, when the balance is skewed towards a single mechanism, health care networks might fail to promote one or more of the ethical requirements.
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Affiliation(s)
- Kasper Raus
- Ghent University Hospital, Ghent, BE
- Department of Philosophy and Moral Sciences, Ghent University, Ghent, BE
| | - Eric Mortier
- Ghent University Hospital, Ghent, BE
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, BE
| | - Kristof Eeckloo
- Ghent University Hospital, Ghent, BE
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Ghent, BE
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18
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Grol SM, Molleman GRM, Kuijpers A, van der Sande R, Fransen GAJ, Assendelft WJJ, Schers HJ. The role of the general practitioner in multidisciplinary teams: a qualitative study in elderly care. BMC FAMILY PRACTICE 2018; 19:40. [PMID: 29523092 PMCID: PMC5845178 DOI: 10.1186/s12875-018-0726-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 03/01/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the western world, a growing number of the older people live at home. In the Netherlands, GPs are expected to play a pivotal role in the organization of integrated care for this patient group. However, little is known about how GPs can play this role best. Our aim for this study was to unravel how GPs can play a successful role in elderly care, in particular in multidisciplinary teams, and to define key concepts for success. METHODS A mixed qualitative research model in four multidisciplinary teams for elderly care in the Netherlands was used. With these four teams, consisting of 46 health care and social service professionals, we carried out two rounds of focus-group interviews. Moreover, we performed semi-structured interviews with four GPs. We analysed data using a hybrid inductive/deductive thematic analysis. RESULTS According to the health care and social service professionals in our study, the role of GPs in multidisciplinary teams for elderly care was characterized by the ability to 'see the bigger picture'. We identified five key activities that constitute a successful GP role: networking, facilitating, team building, integrating care elements, and showing leadership. Practice setting and phase of multidisciplinary team development influenced the way in which GPs fulfilled their roles. According to team members, GPs were the central professionals in care services for older people. The opinions of GPs about their own roles were diverse. CONCLUSIONS GPs took an important role in successful care settings for older people. Five key concepts seemed to be important for best practices in care for frail older people: networking (community), facilitating (organization), team building (professional), integrating care elements (patient), and leadership (personal). Team members from primary care and social services indicated that GPs had an indispensable role in such teams. It would be advantageous for GPs to be aware of this attributed role. Attention to leadership competencies and to the diversity of roles in multidisciplinary teams in GP training programmes seems useful. The challenge is to convince GPs to take a lead, also when they are not inclined to take this role in organizing multidisciplinary teams for older people.
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Affiliation(s)
- Sietske M. Grol
- Department of Primary and Community Care, Radboud University Medical Center, route 119, PO Box 9101, 6500 HB Nijmegen, the Netherlands
| | - Gerard R. M. Molleman
- Department of Primary and Community Care, Radboud University Medical Center, route 119, PO Box 9101, 6500 HB Nijmegen, the Netherlands
- Department of Healthy Living, Community Health Service Gelderland-Zuid, POB 1120, 6501 BC Nijmegen, the Netherlands
| | - Anne Kuijpers
- Department of Primary and Community Care, Radboud University Medical Center, route 119, PO Box 9101, 6500 HB Nijmegen, the Netherlands
| | - Rob van der Sande
- Lectureship of primary and community care, Han University of Applied Sciences, POB 6960, 6503 GL Nijmegen, the Netherlands
| | - Gerdine A. J. Fransen
- Department of Primary and Community Care, Radboud University Medical Center, route 119, PO Box 9101, 6500 HB Nijmegen, the Netherlands
- Department of Healthy Living, Community Health Service Gelderland-Zuid, POB 1120, 6501 BC Nijmegen, the Netherlands
| | - Willem J. J. Assendelft
- Department of Primary and Community Care, Radboud University Medical Center, route 119, PO Box 9101, 6500 HB Nijmegen, the Netherlands
| | - Henk J. Schers
- Department of Primary and Community Care, Radboud University Medical Center, route 119, PO Box 9101, 6500 HB Nijmegen, the Netherlands
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Auschra C. Barriers to the Integration of Care in Inter-Organisational Settings: A Literature Review. Int J Integr Care 2018; 18:5. [PMID: 29632455 PMCID: PMC5887071 DOI: 10.5334/ijic.3068] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 10/31/2017] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION In recent years, inter-organisational collaboration between healthcare organisations has become of increasingly vital importance in order to improve the integration of health service delivery. However, different barriers reported in academic literature seem to hinder the formation and development of such collaboration. THEORY AND METHODS This systematic literature review of forty studies summarises and categorises the barriers to integrated care in inter-organisational settings as reported in previous studies. It analyses how these barriers operate. RESULTS Within these studies, twenty types of barriers have been identified and then categorised in six groups (barriers related to administration and regulation, barriers related to funding, barriers related to the inter-organisational domain, barriers related to the organisational domain, barriers related to service delivery, and barriers related to clinical practices). Not all of these barriers emerge passively, some are set up intentionally. They are not only context-specific, but are also often related and influence each other. DISCUSSION AND CONCLUSION The compilation of these results allows for a better understanding of the characteristics and reasons for the occurrence of barriers that impede collaboration aiming for the integration of care, not only for researchers but also for practitioners. It can help to explain and counteract the slow progress and limited efficiency and effectiveness of some of the inter-organisational collaboration in healthcare settings.
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Affiliation(s)
- Carolin Auschra
- Freie Universität Berlin, Department of Management, Boltzmannstr. 20, 14195 Berlin, DE
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20
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Hashem F, Merritt R. Supporting patients self-managing respiratory health: a qualitative study on the impact of the Breathe Easy voluntary group network. ERJ Open Res 2018; 4:00076-2017. [PMID: 29450201 PMCID: PMC5809141 DOI: 10.1183/23120541.00076-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/14/2017] [Indexed: 11/09/2022] Open
Abstract
Self-management strategies are designed to improve lung and respiratory health through structured self-management plans with regular practitioner reviews. Strategies have not, however, focused upon how patient support groups and advocacy networks can help with the management of these conditions; therefore, it is unknown what impact they may have on patient self-management. A qualitative study was designed to help understand what impact the British Lung Foundation's Breathe Easy (BE) groups have on patients managing their lung and respiratory conditions. A semistructured telephone interview schedule was developed to study the network. Topics covered included: perceptions about the BE groups; current referrals systems and integration pathways; benefits of attending the BE groups; and integration of the BE groups into the respiratory pathway. Key themes explored included: shared patient experience and peer support; patient self-management and self-education; attendance of healthcare professionals; and the impact of integrating BE groups into the respiratory pathway. BE networks were shown to support self-care initiatives for people attending the groups, and members expressed a social and educational benefit. BE networks were working with the local National Health Service to become an integral part of the respiratory pathway, yet there was evidence of resistance from the health service in incorporating the networks.
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21
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Park CSY, Park E. Factors Influencing Patient-Perceived Satisfaction With Community-Based Case Management Services. West J Nurs Res 2017; 40:1598-1613. [PMID: 28580857 DOI: 10.1177/0193945917711116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to identify factors that significantly affect patient-perceived satisfaction with community-based case management services and provide practical strategies for improving patient-perceived quality of care. Secondary data analyses were performed in 2010, 2013, 2015, and 2016, which included Pearson's and Spearman's correlation, Mann-Whitney U and Kruskal-Wallis tests, and stepwise multiple regression. The response variable was measured by the Korean Patient-Perceived Satisfaction Scale of Community-Based Case Management Services (Korean-PSCCM; a 10-level Likert-type scale), whereas explanatory variables were derived from prior studies. Significant predictors of patient-perceived satisfaction with community-based case management services included "capacity to change," "patient-perceived time spent with a case manager," "support/advocacy," "working period," and "emotional connectedness."
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Affiliation(s)
- Claire Su-Yeon Park
- 1 Center for Econometric Optimization in the Nursing Workforce, Seoul, Republic of Korea
| | - Eunok Park
- 2 Jeju National University, Republic of Korea
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Slomic M, Soberg HL, Sveen U, Christiansen B. Transitions of patients with traumatic brain injury and multiple trauma between specialized and municipal rehabilitation services—Professionals’ perspectives. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1320849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Mirela Slomic
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
| | - Helene L. Soberg
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Bjørg Christiansen
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
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Rustad EC, Cronfalk BS, Furnes B, Dysvik E. Continuity of Care during Care Transition: Nurses’ Experiences and Challenges. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojn.2017.72023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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