Pub Date : 2019-09-01DOI: 10.1177/2053434519897146
H. Vrijhoef
{"title":"Towards seamless health care: no theory, no glory","authors":"H. Vrijhoef","doi":"10.1177/2053434519897146","DOIUrl":"https://doi.org/10.1177/2053434519897146","url":null,"abstract":"","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"107 - 108"},"PeriodicalIF":1.4,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519897146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42063806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1177/2053434519895418
J. Symons, Julie Jamison, Jane Dening, L. Murray, Sue Pearson
Introduction This study explored the factors influencing effective care coordination in a community physical rehabilitation service. The two research questions answered were “What was effective care coordination?” and “What were the barriers and enablers?” Methods This qualitative study, influenced by an interprofessional skill framework, was conducted in a regional service in Australia. Participants were 35 allied health, nursing, and client administration team members. Individual interviews, group observations, and focus groups generated data. This article will present the descriptive thematic analysis method and results. Results Care coordination resulted from a suite of informal and formal tools that smoothed the client’s rehabilitation journey. Effectiveness and efficiency were sought alongside client-centred, holistic, and flexible yet consistent approaches to care coordination. All staff undertook care coordination relevant to their managerial, clinical, or administration support roles. The involvement of many people and processes required effective teamwork, notably communication, collaboration, coordination, and navigation of stakeholder differences. The barriers to and enablers of care coordination were the service’s resources including integrated workspaces, transport and communication systems, and the individuals’ resources including clinical reasoning skills in, and familiarity and buy in with care coordination and rehabilitation. Discussion Staff viewed care coordination as an integral and valued part of rehabilitation, with some responsibilities shared by all staff. Additional time and support were required for stakeholders to enact their assigned care coordination roles. Effective care coordination required staff to be trained and competent in interprofessional collaboration. Systems that were efficient to use and encouraged accountability were desired.
{"title":"A qualitative study of care coordination in community physical rehabilitation","authors":"J. Symons, Julie Jamison, Jane Dening, L. Murray, Sue Pearson","doi":"10.1177/2053434519895418","DOIUrl":"https://doi.org/10.1177/2053434519895418","url":null,"abstract":"Introduction This study explored the factors influencing effective care coordination in a community physical rehabilitation service. The two research questions answered were “What was effective care coordination?” and “What were the barriers and enablers?” Methods This qualitative study, influenced by an interprofessional skill framework, was conducted in a regional service in Australia. Participants were 35 allied health, nursing, and client administration team members. Individual interviews, group observations, and focus groups generated data. This article will present the descriptive thematic analysis method and results. Results Care coordination resulted from a suite of informal and formal tools that smoothed the client’s rehabilitation journey. Effectiveness and efficiency were sought alongside client-centred, holistic, and flexible yet consistent approaches to care coordination. All staff undertook care coordination relevant to their managerial, clinical, or administration support roles. The involvement of many people and processes required effective teamwork, notably communication, collaboration, coordination, and navigation of stakeholder differences. The barriers to and enablers of care coordination were the service’s resources including integrated workspaces, transport and communication systems, and the individuals’ resources including clinical reasoning skills in, and familiarity and buy in with care coordination and rehabilitation. Discussion Staff viewed care coordination as an integral and valued part of rehabilitation, with some responsibilities shared by all staff. Additional time and support were required for stakeholders to enact their assigned care coordination roles. Effective care coordination required staff to be trained and competent in interprofessional collaboration. Systems that were efficient to use and encouraged accountability were desired.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"148 - 156"},"PeriodicalIF":1.4,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519895418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43811816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-19DOI: 10.1177/2053434519856866
S. Lelorain, C. Moreaux, V. Christophe, F. Weingertner, H. Bricout
Introduction Continuity of care has many positive outcomes. Yet, in oncology, it may rapidly be disrupted. It is therefore essential to investigate the perceptions of users. Our aim was thus to describe and compare the perceptions of cancer care continuity of patients, family caregivers and various healthcare professionals involved in cancer care in France, one of the countries most affected by cancer. Methods The urology and senology cancer departments of two hospitals, as well as community physicians, were involved: 54 hospital healthcare professionals including mainly physicians, nurses and medical secretaries; 12 city physicians; 41 patients and their family caregivers. We carried out a qualitative study using N-Vivo® and a deductive approach to code the interviews into the following dimensions of continuity: informational, organisational and relational. Results Three different perspectives were highlighted: hospital healthcare professionals primarily focused on organisational aspects (71% of their discourse), city physicians on their need for information from hospitals (40% of their discourse) and patients/caregivers on relational aspects with professionals (51% of their discourse). However, the three dimensions of continuity were intertwined, as the major focus of each type of participant impacted their perspective of the other spheres of coordination. Discussion Working on the main perspective of each category of person involved in cancer care could improve, in turn, the other spheres of continuity for these people. For example, dealing with organisational issues with hospital physicians could be an indirect and original way to enhance their relationships with patients, which are so important to the latter.
{"title":"Cancer care continuity: A qualitative study on the experiences of French healthcare professionals, patients and family caregivers","authors":"S. Lelorain, C. Moreaux, V. Christophe, F. Weingertner, H. Bricout","doi":"10.1177/2053434519856866","DOIUrl":"https://doi.org/10.1177/2053434519856866","url":null,"abstract":"Introduction Continuity of care has many positive outcomes. Yet, in oncology, it may rapidly be disrupted. It is therefore essential to investigate the perceptions of users. Our aim was thus to describe and compare the perceptions of cancer care continuity of patients, family caregivers and various healthcare professionals involved in cancer care in France, one of the countries most affected by cancer. Methods The urology and senology cancer departments of two hospitals, as well as community physicians, were involved: 54 hospital healthcare professionals including mainly physicians, nurses and medical secretaries; 12 city physicians; 41 patients and their family caregivers. We carried out a qualitative study using N-Vivo® and a deductive approach to code the interviews into the following dimensions of continuity: informational, organisational and relational. Results Three different perspectives were highlighted: hospital healthcare professionals primarily focused on organisational aspects (71% of their discourse), city physicians on their need for information from hospitals (40% of their discourse) and patients/caregivers on relational aspects with professionals (51% of their discourse). However, the three dimensions of continuity were intertwined, as the major focus of each type of participant impacted their perspective of the other spheres of coordination. Discussion Working on the main perspective of each category of person involved in cancer care could improve, in turn, the other spheres of continuity for these people. For example, dealing with organisational issues with hospital physicians could be an indirect and original way to enhance their relationships with patients, which are so important to the latter.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"58 - 68"},"PeriodicalIF":1.4,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519856866","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41638156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-19DOI: 10.1177/2053434519858833
H. Vrijhoef
{"title":"Going beyond connecting the dots","authors":"H. Vrijhoef","doi":"10.1177/2053434519858833","DOIUrl":"https://doi.org/10.1177/2053434519858833","url":null,"abstract":"","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"49 - 50"},"PeriodicalIF":1.4,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519858833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48847754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-19DOI: 10.1177/2053434519857582
Julia P Brockway, Keerti Murari, Alexandra Rosenberg, Orit Saigh, M. Press, Jenny J. Lin
Introduction Management of comorbid diseases in patients with cancer is often unclear. The purpose of our study was to identify differences and similarities between primary care providers and oncologists’ knowledge, attitudes, and beliefs regarding coordination of care and comorbid disease management for patients undergoing active cancer treatment. Methods We conducted a cross-sectional study using an anonymous self-administered survey which was available to approximately 600 providers in primary care and medical oncology practicing in both outpatient and inpatient settings from March to December 2014 at three academic hospitals in New York City (Mount Sinai Hospital, Mount Sinai Beth Israel, and Weill Cornell). Our survey instrument assessed physician knowledge, attitudes, and beliefs using a clinical vignette of a cancer patient undergoing active treatment. Descriptive statistics were used to summarize the demographic and practice details of survey responses, and univariate analyses were used to assess differences in responses between primary care providers and oncologists. Results The survey was completed by 203 providers, including 127 primary care providers (62.5%), 32 medical oncologists (15.8%), 11 palliative care physicians (5.4%), and 33 nurse practitioners or physician assistants (16.3%). Medical oncologists admitted more uncertainty regarding who should manage preventive care as compared to primary care providers (34.4% vs. 16.5%, p = 0.02), whereas primary care providers were more concerned about duplicated care (22.8% vs. 6.3%, p = 0.03). Both primary care providers and medical oncologists agreed that diabetes should be actively managed during cancer treatment. More primary care providers felt less strict glycemic control was allowable (56.8% vs. 37.5%, p = 0.05) and that it is allowable for patients to miss some diabetes-related visits (80.6% vs. 56.3%, p = 0.01). Discussion Primary care providers and medical oncologists differ in their knowledge, attitudes, and beliefs regarding coordination of care and management of comorbid conditions in patients undergoing cancer treatment. These differences reflect systemic challenges to provision of care to cancer patients and the need for a model of care coordination.
{"title":"Differences in primary care providers’ and oncologists’ views on communication and coordination of care during active treatment of patients with cancer and comorbidities","authors":"Julia P Brockway, Keerti Murari, Alexandra Rosenberg, Orit Saigh, M. Press, Jenny J. Lin","doi":"10.1177/2053434519857582","DOIUrl":"https://doi.org/10.1177/2053434519857582","url":null,"abstract":"Introduction Management of comorbid diseases in patients with cancer is often unclear. The purpose of our study was to identify differences and similarities between primary care providers and oncologists’ knowledge, attitudes, and beliefs regarding coordination of care and comorbid disease management for patients undergoing active cancer treatment. Methods We conducted a cross-sectional study using an anonymous self-administered survey which was available to approximately 600 providers in primary care and medical oncology practicing in both outpatient and inpatient settings from March to December 2014 at three academic hospitals in New York City (Mount Sinai Hospital, Mount Sinai Beth Israel, and Weill Cornell). Our survey instrument assessed physician knowledge, attitudes, and beliefs using a clinical vignette of a cancer patient undergoing active treatment. Descriptive statistics were used to summarize the demographic and practice details of survey responses, and univariate analyses were used to assess differences in responses between primary care providers and oncologists. Results The survey was completed by 203 providers, including 127 primary care providers (62.5%), 32 medical oncologists (15.8%), 11 palliative care physicians (5.4%), and 33 nurse practitioners or physician assistants (16.3%). Medical oncologists admitted more uncertainty regarding who should manage preventive care as compared to primary care providers (34.4% vs. 16.5%, p = 0.02), whereas primary care providers were more concerned about duplicated care (22.8% vs. 6.3%, p = 0.03). Both primary care providers and medical oncologists agreed that diabetes should be actively managed during cancer treatment. More primary care providers felt less strict glycemic control was allowable (56.8% vs. 37.5%, p = 0.05) and that it is allowable for patients to miss some diabetes-related visits (80.6% vs. 56.3%, p = 0.01). Discussion Primary care providers and medical oncologists differ in their knowledge, attitudes, and beliefs regarding coordination of care and management of comorbid conditions in patients undergoing cancer treatment. These differences reflect systemic challenges to provision of care to cancer patients and the need for a model of care coordination.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"51 - 57"},"PeriodicalIF":1.4,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519857582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43584776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-01DOI: 10.1177/2053434519857352
Sofie Hermans, A. Sevenants, Anja Declercq, N. Broeck, L. Deliens, Joachim Cohen, C. Audenhove
Introduction Multiple care organisations, such as home care services, nursing homes and hospitals, are responsible for providing an appropriate response to the palliative care needs of older people admitted into long-term care facilities. Integrated palliative care aims to provide seamless and continuous care. A possible organisational strategy to help realise integrated palliative care for this population is to create a network in which these organisations collaborate. The aim is to analyse the collaboration processes of the various organisations involved in providing palliative care to nursing home residents. Method A sequential mixed-methods study, including a survey sent to 502 participants to evaluate the collaboration between home and residential care, and between hospital and residential care, and additionally three focus group interviews involving a purposive selection among the survey participants. Participants are key persons from the nursing homes, hospitals and home care organisations that are part of the 15 Flemish palliative care networks dispersed throughout the region of Flanders, Belgium. Results Survey data were gathered from 308 key persons (response rate: 61%), and 16 people participated in three focus group interviews. Interpersonal dimensions of collaboration are rated higher than structural dimensions. This effect is statistically significant. Qualitative analyses identified guidelines, education, and information-transfer as structural challenges. Additionally, for further development, members should become acquainted and the network should prioritise the establishment of a communication infrastructure, shared leadership support and formalisation. Discussion The insights of key persons suggest the need for further structuration and can serve as a guideline for interventions directed at improving inter-organisational collaboration in palliative care trajectories for nursing home residents.
{"title":"Inter-organisational collaboration in palliative care trajectories for nursing home residents: A nation-wide mixed methods study among key persons","authors":"Sofie Hermans, A. Sevenants, Anja Declercq, N. Broeck, L. Deliens, Joachim Cohen, C. Audenhove","doi":"10.1177/2053434519857352","DOIUrl":"https://doi.org/10.1177/2053434519857352","url":null,"abstract":"Introduction Multiple care organisations, such as home care services, nursing homes and hospitals, are responsible for providing an appropriate response to the palliative care needs of older people admitted into long-term care facilities. Integrated palliative care aims to provide seamless and continuous care. A possible organisational strategy to help realise integrated palliative care for this population is to create a network in which these organisations collaborate. The aim is to analyse the collaboration processes of the various organisations involved in providing palliative care to nursing home residents. Method A sequential mixed-methods study, including a survey sent to 502 participants to evaluate the collaboration between home and residential care, and between hospital and residential care, and additionally three focus group interviews involving a purposive selection among the survey participants. Participants are key persons from the nursing homes, hospitals and home care organisations that are part of the 15 Flemish palliative care networks dispersed throughout the region of Flanders, Belgium. Results Survey data were gathered from 308 key persons (response rate: 61%), and 16 people participated in three focus group interviews. Interpersonal dimensions of collaboration are rated higher than structural dimensions. This effect is statistically significant. Qualitative analyses identified guidelines, education, and information-transfer as structural challenges. Additionally, for further development, members should become acquainted and the network should prioritise the establishment of a communication infrastructure, shared leadership support and formalisation. Discussion The insights of key persons suggest the need for further structuration and can serve as a guideline for interventions directed at improving inter-organisational collaboration in palliative care trajectories for nursing home residents.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"69 - 80"},"PeriodicalIF":1.4,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519857352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42126841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-01DOI: 10.1177/2053434519858028
Jennifer L Sullivan, Dana Beth Weinburg, Stefanie Gidmark, Ryann L Engle, Victoria A Parker, Denise A Tyler
Introduction: Previous research in acute care settings has shown that collaborative capacity, defined as the way providers collaborate as equal team members, can be improved by the ways in which an organization supports its staff and teams. This observational cross-sectional study examines the association between collaborative capacity and supportive organizational context, supervisory support, and person-centered care in nursing homes to determine if similar relationships exist.
Methods: We adapted the Care Coordination Survey for nursing homes and administered it to clinical staff in 20 VA Community Living Centers. We used random effects models to examine the associations between supportive organizational context, supervisory support, and person-centered care with collaborative capacity outcomes including quality of staff interactions, task independence, and collaborative influence.
Results: A total of 723 Community Living Center clinical staff participated in the Care Coordination Survey resulting in a response rate of 29%. We found that teamwork and collaboration-measured as task interdependence, quality of interactions and collaborative influence-did not differ significantly between Community Living Centers but did differ significantly across occupational groups. Moreover, staff members' experiences of teamwork and collaboration were positively associated with supportive organizational context and person-centered care.
Discussion: Our findings suggest that elements of organizational context are important to facilitating collaborative capacity. Additionally, investing in staffing, rewards, and person-centered care may improve teamwork.
{"title":"Collaborative capacity and patient-centered care in the Veterans' Health Administration Community Living Centers.","authors":"Jennifer L Sullivan, Dana Beth Weinburg, Stefanie Gidmark, Ryann L Engle, Victoria A Parker, Denise A Tyler","doi":"10.1177/2053434519858028","DOIUrl":"https://doi.org/10.1177/2053434519858028","url":null,"abstract":"<p><strong>Introduction: </strong>Previous research in acute care settings has shown that collaborative capacity, defined as the way providers collaborate as equal team members, can be improved by the ways in which an organization supports its staff and teams. This observational cross-sectional study examines the association between collaborative capacity and supportive organizational context, supervisory support, and person-centered care in nursing homes to determine if similar relationships exist.</p><p><strong>Methods: </strong>We adapted the Care Coordination Survey for nursing homes and administered it to clinical staff in 20 VA Community Living Centers. We used random effects models to examine the associations between supportive organizational context, supervisory support, and person-centered care with collaborative capacity outcomes including quality of staff interactions, task independence, and collaborative influence.</p><p><strong>Results: </strong>A total of 723 Community Living Center clinical staff participated in the Care Coordination Survey resulting in a response rate of 29%. We found that teamwork and collaboration-measured as task interdependence, quality of interactions and collaborative influence-did not differ significantly between Community Living Centers but did differ significantly across occupational groups. Moreover, staff members' experiences of teamwork and collaboration were positively associated with supportive organizational context and person-centered care.</p><p><strong>Discussion: </strong>Our findings suggest that elements of organizational context are important to facilitating collaborative capacity. Additionally, investing in staffing, rewards, and person-centered care may improve teamwork.</p>","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 2","pages":"90-99"},"PeriodicalIF":1.4,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519858028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-23DOI: 10.1177/2053434519848671
J. Dickinson
When we started our Call&Check journey of discovery in 2012, we wanted to provide a new service that would help our ageing communities. We are continuing to grow and develop the concept we feel the word is certainly spreading. All countries have a postal operator and a rapidly ageing demography, which are the two main ingredients you need to develop a Call&Check service, along with a will to do it. What we do know is that Call&Check works not only for the elders in our communities but for many others who need that little extra support to live at home.
{"title":"Call&Check: A community service which disrupts the norm","authors":"J. Dickinson","doi":"10.1177/2053434519848671","DOIUrl":"https://doi.org/10.1177/2053434519848671","url":null,"abstract":"When we started our Call&Check journey of discovery in 2012, we wanted to provide a new service that would help our ageing communities. We are continuing to grow and develop the concept we feel the word is certainly spreading. All countries have a postal operator and a rapidly ageing demography, which are the two main ingredients you need to develop a Call&Check service, along with a will to do it. What we do know is that Call&Check works not only for the elders in our communities but for many others who need that little extra support to live at home.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"100 - 103"},"PeriodicalIF":1.4,"publicationDate":"2019-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519848671","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44319249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-31DOI: 10.1177/2053434519840458
C. Domingo, Iratxe Regidor, E. Alonso, A. Besga, D. Orozco, R. Nuño
Introduction Patients with heart failure are usually a frail population characterised by complex care needs. To ensure an integrated care approach, it is necessary to work collaboratively across organisational boundaries. The purpose of this study is to measure and understand the perception of collaboration between clinicians participating in a comprehensive care programme for patients with heart failure, known as PROMIC. Methods A sequential mixed-method study design was used. A sample of PROMIC clinicians completed a survey in which they evaluated 10 dimensions of collaboration in 2010 and in 2014. The perspectives of clinicians were studied more in depth in a focus group in 2012, which was analysed using content analysis. Outcomes: Professionals’ perception of collaboration showed an improvement by 1.18 points (53%) over the period 2010–14. The comprehensive programme proved to be of major support to the professionals. Sometimes, the study participants did not feel prepared to manage cases due to the complexity of the situations with regard to patients’ care. Both, the quantitative and the qualitative methods, showed up a congruent information about the positive perception of participants of the programme itself and the collaboration. Discussion The complexity of care processes and the need for continuity of care mean that large-scale collaboration is necessary between care levels as well as major interdisciplinary teamwork, to achieve the best possible outcomes in terms of health. ProMIC intervention has helped to improve professionals’ perception in terms of collaboration between levels.
{"title":"Healthcare staff perceptions of integrated care in a programme for complex chronic patients admitted to hospital because of heart failure (ProMIC)","authors":"C. Domingo, Iratxe Regidor, E. Alonso, A. Besga, D. Orozco, R. Nuño","doi":"10.1177/2053434519840458","DOIUrl":"https://doi.org/10.1177/2053434519840458","url":null,"abstract":"Introduction Patients with heart failure are usually a frail population characterised by complex care needs. To ensure an integrated care approach, it is necessary to work collaboratively across organisational boundaries. The purpose of this study is to measure and understand the perception of collaboration between clinicians participating in a comprehensive care programme for patients with heart failure, known as PROMIC. Methods A sequential mixed-method study design was used. A sample of PROMIC clinicians completed a survey in which they evaluated 10 dimensions of collaboration in 2010 and in 2014. The perspectives of clinicians were studied more in depth in a focus group in 2012, which was analysed using content analysis. Outcomes: Professionals’ perception of collaboration showed an improvement by 1.18 points (53%) over the period 2010–14. The comprehensive programme proved to be of major support to the professionals. Sometimes, the study participants did not feel prepared to manage cases due to the complexity of the situations with regard to patients’ care. Both, the quantitative and the qualitative methods, showed up a congruent information about the positive perception of participants of the programme itself and the collaboration. Discussion The complexity of care processes and the need for continuity of care mean that large-scale collaboration is necessary between care levels as well as major interdisciplinary teamwork, to achieve the best possible outcomes in terms of health. ProMIC intervention has helped to improve professionals’ perception in terms of collaboration between levels.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"81 - 89"},"PeriodicalIF":1.4,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519840458","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44857628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.1177/2053434519839195
D. Seys, M. Panella, M. Panella, R. vanZelm, W. Sermeus, Daan Aeyels, L. Bruyneel, E. Coeckelberghs, K. Vanhaecht
Care pathway implementation is characterised by a dual complexity. A care pathway itself represents a complex intervention with multiple interacting and interdependent intervention components and outcomes. The organisations in which care pathways are being implemented represent complex systems that need to be directed at change through an in-depth understanding of their external and internal context in which they are functioning in. This study sets out a new evidence-based and pragmatic framework that unpacks how intervention mechanisms, intervention fidelity and care context are converge and represent interacting processes that determine success or failure of the care pathway. We recommend researchers looking to increase the effectiveness of care pathway implementation and accelerate improvement of desired outcomes to adopt this framework from inception to implementation of the intervention.
{"title":"Care pathways are complex interventions in complex systems: New European Pathway Association framework","authors":"D. Seys, M. Panella, M. Panella, R. vanZelm, W. Sermeus, Daan Aeyels, L. Bruyneel, E. Coeckelberghs, K. Vanhaecht","doi":"10.1177/2053434519839195","DOIUrl":"https://doi.org/10.1177/2053434519839195","url":null,"abstract":"Care pathway implementation is characterised by a dual complexity. A care pathway itself represents a complex intervention with multiple interacting and interdependent intervention components and outcomes. The organisations in which care pathways are being implemented represent complex systems that need to be directed at change through an in-depth understanding of their external and internal context in which they are functioning in. This study sets out a new evidence-based and pragmatic framework that unpacks how intervention mechanisms, intervention fidelity and care context are converge and represent interacting processes that determine success or failure of the care pathway. We recommend researchers looking to increase the effectiveness of care pathway implementation and accelerate improvement of desired outcomes to adopt this framework from inception to implementation of the intervention.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 1","pages":"5 - 9"},"PeriodicalIF":1.4,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434519839195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46332614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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