Pub Date : 2024-08-08DOI: 10.1108/jica-07-2024-098
Axel Kaehne
{"title":"Editorial: Integrated care’s missing piece: the US experience","authors":"Axel Kaehne","doi":"10.1108/jica-07-2024-098","DOIUrl":"https://doi.org/10.1108/jica-07-2024-098","url":null,"abstract":"","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927450","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 : 2024-07-25DOI: 10.1108/jica-08-2023-0060
Märt Vesinurm, Inka Sylgren, Annika Bengts, P. Torkki, P. Lillrank
PurposeThis article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.Design/methodology/approachThe method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.FindingsPJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.Research limitations/implicationsThis study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.Practical implicationsWe believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.Originality/valueManagerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.
{"title":"Concept analysis of patient journey disruptions: the obstacle of integrated care","authors":"Märt Vesinurm, Inka Sylgren, Annika Bengts, P. Torkki, P. Lillrank","doi":"10.1108/jica-08-2023-0060","DOIUrl":"https://doi.org/10.1108/jica-08-2023-0060","url":null,"abstract":"PurposeThis article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.Design/methodology/approachThe method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.FindingsPJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.Research limitations/implicationsThis study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.Practical implicationsWe believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.Originality/valueManagerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802531","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 : 2024-07-12DOI: 10.1108/jica-05-2023-0028
Leahora Rotteau, Mercedes Magaz, Brian M. Wong, Sara Shearkhani, Mohammad Shabani, Rishma Pradhan, Bourne Auguste, Laurie Bourne, Jeff Powis, K. Smith
PurposeAn integrated care system identified quality improvement (QI) capacity as a gap in advancing their integrated quality care priorities and improvement efforts. Here we describe the design and implementation of a QI capacity building program that aimed to (1) build QI capacity amongst diverse integrated care system members and (2) apply QI principles to advance integrated quality care priorities.Design/methodology/approachThe integrated care system leaders, including community members, partnered with the University of Toronto Centre for Quality Improvement and Patient Safety to co-design and deliver the QI capacity building program focused on improving cancer screening rates. An existing acute care capacity building program was adapted. Content included QI tools, data to identify and monitor QI priorities, equity considerations, and empowering participants as change agents.FindingsParticipants were satisfied with the content and delivery of the program. Some described using QI tools and strategies in practice following the workshop. Challenges to using the tools included the current pressures facing primary care and the health system, resources, and data availability.Practical implicationsThis QI capacity building program was challenging but feasible. Clarifying the target audience, being attentive to co-design, acknowledging post-pandemic system challenges and proactively addressing variable knowledge and barriers to QI work in practice will inform future iterations of this program.Originality/valueWhile many examples of QI education programs exist, the majority target a single healthcare sector. We describe a novel QI capacity building model that bridges healthcare sectors and includes patient partners and community members as teachers and participants.
{"title":"Community-engaged co-design of a quality improvement capacity building program within an integrated health system in Ontario, Canada","authors":"Leahora Rotteau, Mercedes Magaz, Brian M. Wong, Sara Shearkhani, Mohammad Shabani, Rishma Pradhan, Bourne Auguste, Laurie Bourne, Jeff Powis, K. Smith","doi":"10.1108/jica-05-2023-0028","DOIUrl":"https://doi.org/10.1108/jica-05-2023-0028","url":null,"abstract":"PurposeAn integrated care system identified quality improvement (QI) capacity as a gap in advancing their integrated quality care priorities and improvement efforts. Here we describe the design and implementation of a QI capacity building program that aimed to (1) build QI capacity amongst diverse integrated care system members and (2) apply QI principles to advance integrated quality care priorities.Design/methodology/approachThe integrated care system leaders, including community members, partnered with the University of Toronto Centre for Quality Improvement and Patient Safety to co-design and deliver the QI capacity building program focused on improving cancer screening rates. An existing acute care capacity building program was adapted. Content included QI tools, data to identify and monitor QI priorities, equity considerations, and empowering participants as change agents.FindingsParticipants were satisfied with the content and delivery of the program. Some described using QI tools and strategies in practice following the workshop. Challenges to using the tools included the current pressures facing primary care and the health system, resources, and data availability.Practical implicationsThis QI capacity building program was challenging but feasible. Clarifying the target audience, being attentive to co-design, acknowledging post-pandemic system challenges and proactively addressing variable knowledge and barriers to QI work in practice will inform future iterations of this program.Originality/valueWhile many examples of QI education programs exist, the majority target a single healthcare sector. We describe a novel QI capacity building model that bridges healthcare sectors and includes patient partners and community members as teachers and participants.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141652275","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 : 2024-07-11DOI: 10.1108/jica-12-2023-0094
Floor Kist, Hans de Bruijn, Catholijn Jonker
PurposeThe objective of this paper is to develop a redesigned commissioning process for social care services that fosters integrated care, encourages collaboration and balances professional expertise with client engagement.Design/methodology/approachThis study employs a two-pronged approach: a case study of a municipality’s use of subsidy tables and a literature scoping review on integrated care research.FindingsThe paper introduces a new framework for the study of the new “subsidy tables.” A well-defined and extensive consultation process involving both social care providers (suppliers), the Service Triad, and client representation adds to the existing research on supplier consultation, and on how to define the outcomes for clients via client engagement.Research limitations/implicationsWhile aspects are clearly relevant to the Netherlands, the design of the commissioning process of social care has international relevance as well: finding definitions, formulating outcomes and incentives, designing a more collaborative instead of competitive process, stakeholder engagement and consultation.Practical implicationsSeveral Dutch municipalities started using the “subsidy tables” method for commissioning integrated social care. This paper offers clear improvements that benefit the commissioners, the social care providers and their clients.Social implicationsImproving the commissioning process of integrated social care will lead to better fitting care for people who need social care.Originality/valueThis paper is one of the first to do a thorough analysis of the “subsidy tables” method for commissioning integrated social care.
{"title":"Commissioning for integration: exploring the dynamics of the “subsidy tables” approach in Dutch social care delivery","authors":"Floor Kist, Hans de Bruijn, Catholijn Jonker","doi":"10.1108/jica-12-2023-0094","DOIUrl":"https://doi.org/10.1108/jica-12-2023-0094","url":null,"abstract":"PurposeThe objective of this paper is to develop a redesigned commissioning process for social care services that fosters integrated care, encourages collaboration and balances professional expertise with client engagement.Design/methodology/approachThis study employs a two-pronged approach: a case study of a municipality’s use of subsidy tables and a literature scoping review on integrated care research.FindingsThe paper introduces a new framework for the study of the new “subsidy tables.” A well-defined and extensive consultation process involving both social care providers (suppliers), the Service Triad, and client representation adds to the existing research on supplier consultation, and on how to define the outcomes for clients via client engagement.Research limitations/implicationsWhile aspects are clearly relevant to the Netherlands, the design of the commissioning process of social care has international relevance as well: finding definitions, formulating outcomes and incentives, designing a more collaborative instead of competitive process, stakeholder engagement and consultation.Practical implicationsSeveral Dutch municipalities started using the “subsidy tables” method for commissioning integrated social care. This paper offers clear improvements that benefit the commissioners, the social care providers and their clients.Social implicationsImproving the commissioning process of integrated social care will lead to better fitting care for people who need social care.Originality/valueThis paper is one of the first to do a thorough analysis of the “subsidy tables” method for commissioning integrated social care.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141658429","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 : 2024-07-09DOI: 10.1108/jica-03-2024-0015
Mahalakshmi Satyanarayana, Shubha Ranganathan
PurposeThe viewpoint essay focusses on the significance of integrated care (IC) for chronic pain in India, in an attempt to reflect on how pain management and care can be made more accessible and available to patients.Design/methodology/approachThis reflective essay invites looking at chronic pain beyond biomedical perspectives. Insights from the medical humanities and the social sciences are used to emphasise chronic pain as a psychosocial and socio-political phenomenon and not just a biomedical category.FindingsThe essay argues that there are several challenges and barriers to the recognition and validation of chronic pain as a speciality.Originality/valueIC has not received sufficient attention in the Indian context, where medical curricula and training do not sufficiently include an understanding of the multi-faceted aspects surrounding chronic pain. By highlighting the role of humanistic approaches to effectively bridge the gap, this viewpoint essay illustrates the significance of drawing on an integrated or holistic healthcare framework.
{"title":"Reimagining chronic pain management: the case for integrated care in India","authors":"Mahalakshmi Satyanarayana, Shubha Ranganathan","doi":"10.1108/jica-03-2024-0015","DOIUrl":"https://doi.org/10.1108/jica-03-2024-0015","url":null,"abstract":"PurposeThe viewpoint essay focusses on the significance of integrated care (IC) for chronic pain in India, in an attempt to reflect on how pain management and care can be made more accessible and available to patients.Design/methodology/approachThis reflective essay invites looking at chronic pain beyond biomedical perspectives. Insights from the medical humanities and the social sciences are used to emphasise chronic pain as a psychosocial and socio-political phenomenon and not just a biomedical category.FindingsThe essay argues that there are several challenges and barriers to the recognition and validation of chronic pain as a speciality.Originality/valueIC has not received sufficient attention in the Indian context, where medical curricula and training do not sufficiently include an understanding of the multi-faceted aspects surrounding chronic pain. By highlighting the role of humanistic approaches to effectively bridge the gap, this viewpoint essay illustrates the significance of drawing on an integrated or holistic healthcare framework.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665484","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 : 2024-06-17DOI: 10.1108/jica-01-2024-0002
Sonica Rautela, Nehajoan Panackal, Adya Sharma
PurposeIndia has been on the pathway of improvement concerning healthcare and health outcomes of its population. However, India must overcome its unique challenges and cover a long journey ahead. This mandates a need for a high-quality, contemporary and community-based health system that promises consistent and quality healthcare, is trusted and valued by all its citizens, considers the changing population needs and should be affordable and accessible.Design/methodology/approachThe study examines various dimensions and elements associated with the integrated healthcare system in India and uses input, process and output structural measures.FindingsThe present paper proposes an integrated, comprehensive healthcare system in India that endorses participation from diverse stakeholders such as the government, organizations, the community and individuals who can contribute uniquely. It also focuses on defined and measurable output that can make health a topic of social movement or “Jan Andolan” and create a sustainable and integrated care system.Originality/valueThe study is unique as it focuses on the role of stakeholders in health care. The research emphasized the involvement of the government, community, people and organizations in developing an integrated healthcare ecosystem that includes modern technology, skilled employees, enough finance, governance, efficient delivery platforms and top-tier infrastructure. The model’s output is focused on healthcare that is inexpensive, accessible, available, accountable and user-centered. This would gradually improve everyone’s health and well-being.
{"title":"Integrated healthcare system in India: a conceptual framework","authors":"Sonica Rautela, Nehajoan Panackal, Adya Sharma","doi":"10.1108/jica-01-2024-0002","DOIUrl":"https://doi.org/10.1108/jica-01-2024-0002","url":null,"abstract":"PurposeIndia has been on the pathway of improvement concerning healthcare and health outcomes of its population. However, India must overcome its unique challenges and cover a long journey ahead. This mandates a need for a high-quality, contemporary and community-based health system that promises consistent and quality healthcare, is trusted and valued by all its citizens, considers the changing population needs and should be affordable and accessible.Design/methodology/approachThe study examines various dimensions and elements associated with the integrated healthcare system in India and uses input, process and output structural measures.FindingsThe present paper proposes an integrated, comprehensive healthcare system in India that endorses participation from diverse stakeholders such as the government, organizations, the community and individuals who can contribute uniquely. It also focuses on defined and measurable output that can make health a topic of social movement or “Jan Andolan” and create a sustainable and integrated care system.Originality/valueThe study is unique as it focuses on the role of stakeholders in health care. The research emphasized the involvement of the government, community, people and organizations in developing an integrated healthcare ecosystem that includes modern technology, skilled employees, enough finance, governance, efficient delivery platforms and top-tier infrastructure. The model’s output is focused on healthcare that is inexpensive, accessible, available, accountable and user-centered. This would gradually improve everyone’s health and well-being.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335021","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 : 2024-06-04DOI: 10.1108/jica-11-2023-0077
Rachelle Kaye, Theodoros N. Arvanitis, S. N. Lim Choi Keung, Dipak Kalra, Dolores Verdoy Berastegi
PurposeThe European funded project ADLIFE focuses on the application of digitally enabled integrated care for people with advanced chronic diseases. The implementation of the ADLIFE intervention required a robust practical tool that would be common to all pilot sites while allowing flexibility for local variations as well as the ability to adapt to unanticipated changes and problems.Design/methodology/approachThe ADLIFE project combined the concepts of implementation research and formative evaluation with the standardized operating procedures (SOP) methodology. The ADLIFE project significantly modified the SOP approach and used it as a means to not only to define and organize the tasks that needed to be performed in preparing and implementing the ADLIFE intervention but also to create a deeper understanding of the unique challenges faced in each site, as well as a method for achieving a consensus.FindingsThe ADLIFE SOPs were developed by a dedicated working group, and they encompassed the preparatory phase leading up to implementation of the intervention. The SOP was also the basis for monitoring the implementation, and this created a structure for the dynamic ongoing tactical and even strategic changes necessitated by local diversity as well as many unanticipated changes.Originality/valueThe SOP methodology was useful in supporting the development of the ADLIFE SOP, which was a consensus-based approach to guide for managing the implementation process, both at project and local levels. It has supported continuous improvement and learning throughout the project. Both the process and the SOP produced by the process can be readily adapted and used in other similar projects.
{"title":"Implementing digitally enabled integrated healthcare","authors":"Rachelle Kaye, Theodoros N. Arvanitis, S. N. Lim Choi Keung, Dipak Kalra, Dolores Verdoy Berastegi","doi":"10.1108/jica-11-2023-0077","DOIUrl":"https://doi.org/10.1108/jica-11-2023-0077","url":null,"abstract":"PurposeThe European funded project ADLIFE focuses on the application of digitally enabled integrated care for people with advanced chronic diseases. The implementation of the ADLIFE intervention required a robust practical tool that would be common to all pilot sites while allowing flexibility for local variations as well as the ability to adapt to unanticipated changes and problems.Design/methodology/approachThe ADLIFE project combined the concepts of implementation research and formative evaluation with the standardized operating procedures (SOP) methodology. The ADLIFE project significantly modified the SOP approach and used it as a means to not only to define and organize the tasks that needed to be performed in preparing and implementing the ADLIFE intervention but also to create a deeper understanding of the unique challenges faced in each site, as well as a method for achieving a consensus.FindingsThe ADLIFE SOPs were developed by a dedicated working group, and they encompassed the preparatory phase leading up to implementation of the intervention. The SOP was also the basis for monitoring the implementation, and this created a structure for the dynamic ongoing tactical and even strategic changes necessitated by local diversity as well as many unanticipated changes.Originality/valueThe SOP methodology was useful in supporting the development of the ADLIFE SOP, which was a consensus-based approach to guide for managing the implementation process, both at project and local levels. It has supported continuous improvement and learning throughout the project. Both the process and the SOP produced by the process can be readily adapted and used in other similar projects.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141387812","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 : 2024-05-10DOI: 10.1108/jica-08-2023-0065
Jacopo Frassini
PurposeThis article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU. While both systems are driven by the same goal of providing high-quality healthcare services and achieving optimal patient outcomes, they operate under different national approaches and resources.Design/methodology/approachTwo recent crises are presented as examples that highlight the necessity of cooperation between civilian and military medical systems. The Covid-19 Pandemic and the Ukrainian Conflict are described based on the experience gathered by the author as a member of the NATO Centre of Excellence for Military Medicine and form the base to shape a broader perspective on the future of civil-military interaction in healthcare at the European Union level.FindingsThe ability to deliver coordinated responses during crises depend on the level of interoperability, preparation and mutual understanding. To improve synergies, a structured partnership should be established, prioritizing common standards of care and shared best practices. Integrating military and civilian healthcare pathways can be especially beneficial in situations where patients are moved from the point of injury or sickness across different military and civilian structures to receive the most appropriate treatment and rehabilitation for their conditions.Originality/valueThe relationship between military and civilian healthcare systems is often discussed at multinational level, but a clear focus is lacking concerning their shared mission, distinct functions and potential for cross-border collaboration.
{"title":"CIV-MIL integration in the transformation of the EU healthcare network: a dual-gain strategy","authors":"Jacopo Frassini","doi":"10.1108/jica-08-2023-0065","DOIUrl":"https://doi.org/10.1108/jica-08-2023-0065","url":null,"abstract":"PurposeThis article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU. While both systems are driven by the same goal of providing high-quality healthcare services and achieving optimal patient outcomes, they operate under different national approaches and resources.Design/methodology/approachTwo recent crises are presented as examples that highlight the necessity of cooperation between civilian and military medical systems. The Covid-19 Pandemic and the Ukrainian Conflict are described based on the experience gathered by the author as a member of the NATO Centre of Excellence for Military Medicine and form the base to shape a broader perspective on the future of civil-military interaction in healthcare at the European Union level.FindingsThe ability to deliver coordinated responses during crises depend on the level of interoperability, preparation and mutual understanding. To improve synergies, a structured partnership should be established, prioritizing common standards of care and shared best practices. Integrating military and civilian healthcare pathways can be especially beneficial in situations where patients are moved from the point of injury or sickness across different military and civilian structures to receive the most appropriate treatment and rehabilitation for their conditions.Originality/valueThe relationship between military and civilian healthcare systems is often discussed at multinational level, but a clear focus is lacking concerning their shared mission, distinct functions and potential for cross-border collaboration.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140993972","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 : 2024-04-18DOI: 10.1108/jica-01-2024-0003
Ryan J. Chan, S. Isaacksz, Brian Low, Cecile Raymond, Lori Seeton, Christopher T. Chan
PurposeHealth care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.Design/methodology/approachIn this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.FindingsWe describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.Practical implicationsHaving a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.Originality/valueThere is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.
目的医疗保健系统希望采取整合战略，将重点从急症护理转移到更广泛的社区医疗和社会服务上。本文介绍了 UHN Connected Care Hub，这是一种创新型医疗模式，由跨学科团队组成，在社区和医疗机构的合作下，设计可持续、可共享的持续医疗实践。研究结果我们描述了 UHN Connected Care Hub 识别高危人群并合作提供及时护理的能力，详细介绍了这种护理模式在组织微型诊所集中系统，对免疫力低下的患者群体进行 COVID-19（Tixagevimab/cilgavimab [Evusheld]）暴露前预防治疗方面的实际经验。实际意义建立一个集中的微型诊所系统来提供医疗服务，为提高适应性、方便病人就医、加强社区合作和整合提供了机会。扩大服务范围还能为预防性治疗创造新的机会，从而优化在人口层面提供医疗服务的成本效益和质量。我们讨论了具有适当基础设施和医疗合作网络的动态组织如何能够更灵活地应对快速变化的政策和程序，并促进为未来的医疗危机或流行病做好准备。
{"title":"Pop-up micro clinics for pre-exposure prophylaxis of immunocompromised patients","authors":"Ryan J. Chan, S. Isaacksz, Brian Low, Cecile Raymond, Lori Seeton, Christopher T. Chan","doi":"10.1108/jica-01-2024-0003","DOIUrl":"https://doi.org/10.1108/jica-01-2024-0003","url":null,"abstract":"PurposeHealth care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.Design/methodology/approachIn this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.FindingsWe describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.Practical implicationsHaving a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.Originality/valueThere is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689641","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 : 2024-04-17DOI: 10.1108/jica-07-2023-0054
Cinzia Storace, Serafina Esposito, Anna Maria Iannicelli, Carmela Bravaccio
PurposeTo facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.Design/methodology/approachHospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.FindingsPre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.Originality/valueThe analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.
{"title":"Continuity of care. Patient support from hospital-to-territory care plan: protected hospital discharges","authors":"Cinzia Storace, Serafina Esposito, Anna Maria Iannicelli, Carmela Bravaccio","doi":"10.1108/jica-07-2023-0054","DOIUrl":"https://doi.org/10.1108/jica-07-2023-0054","url":null,"abstract":"PurposeTo facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.Design/methodology/approachHospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.FindingsPre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.Originality/valueThe analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140692489","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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