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International Journal of Integrated Care

Marjoleine J C Pieper, Wilco P Achterberg, Jenny T van der Steen, Anneke L Francke
Background: A stepwise, multidisciplinary and multicomponent intervention (called STA OP!) was implemented in Dutch nursing home units, which included a comprehensive multidisciplinary team training. A cluster-randomised controlled trial showed that the intervention reduced symptoms of pain and challenging behaviour. Objectives: To describe the experiences around the implementation of the intervention; to examine the extent to which the STA OP! intervention was delivered and implemented as intended (at the level of the team, and the individual resident/professional); and to understand factors influencing the implementation process...
September 7, 2018: International Journal of Integrated Care
Lisa Altman, Christie Breen, Joanne Ging, Sara Burrett, Tim Hoffmann, Emma Dickins, Kristen Brown, Yvonne Zurynski, Susan Woolfenden
Introduction: Children with medical complexity (CMC) require highly specialised care, often from multiple providers and over many years. This paper describes the first 18 months of development of the Kids Guided Personalised Services (GPS) Integrated Care Program (the Program). This Program aims to improve health care experience; communication and to streamline provision of care. Discussion: Key enablers across the Program were put in place and 5 individual project streams were used to implement change...
September 5, 2018: International Journal of Integrated Care
Monica Sørensen, Una Stenberg, Lisa Garnweidner-Holme
Introduction: Multi-professional collaboration (MPC) is essential for the delivery of effective and comprehensive care services. As in other European countries, primary care in Norway is challenged by altered patient values and the increased expectations of health administrations to participate in team-based care. This scoping review reports on the organisational, processual, relational and contextual facilitators of collaboration between general practitioners (GP) and other healthcare professionals (HCPs) in primary care...
August 30, 2018: International Journal of Integrated Care
Ben Hannigan, Alan Simpson, Michael Coffey, Sally Barlow, Aled Jones
Introduction: Care coordination is intended to ensure needs are met and integrated services are provided. Formalised processes for the coordination of mental health care arrived in the UK with the introduction of the care programme approach in the early 1990s. Since then the care coordinator role has become a central one within mental health systems. Theory and methods: This paper contrasts care coordination as work that is imagined with care coordination as work that is done...
August 23, 2018: International Journal of Integrated Care
Suzanne Lewis, Raechel A Damarell, Jennifer J Tieman, Camilla Trenerry
Introduction: Integrated care research evidence should be optimally visible and accessible to stakeholders. This study examines the contribution of specific databases to the discovery of integrated care evidence, and tests the usefulness of Medical Subject Heading (MeSH) indexing of this literature within PubMed. Methods: We used bibliometric methods to analyse the integrated care literature indexed within six databases between 2007 and 2016. An international expert advisory group assessed the relevance of citations randomly retrieved from PubMed using MeSH term 'Delivery of Health Care, Integrated'...
August 17, 2018: International Journal of Integrated Care
Laura G González-Ortiz, Stefano Calciolari, Nick Goodwin, Viktoria Stein
Objective: As part of the EU-funded Project INTEGRATE, the research sought to develop an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation across varying country contexts and relevant to different chronic and/or long-term conditions. This paper identifies the core dimensions of integrated care based on a review of previous literature on the topic. Methodology: The research reviewed literature evidence from the peer-reviewed and grey literature...
August 8, 2018: International Journal of Integrated Care
Nosaiba Rayan-Gharra, Boaz Tadmor, Ran D Balicer, Efrat Shadmi
Introduction: Patients with low health literacy (HL) and minority patients encounter many challenges during hospital to community transitions. We assessed care transitions of minority patients with various HL levels and tested whether presence of caregivers and provision of language-concordant care are associated with better care transitions. Methods: A prospective cohort study of 598 internal medicine patients, Hebrew, Russian, or Arabic native speakers, at a tertiary medical center in central Israel, from 2013 to 2014...
August 8, 2018: International Journal of Integrated Care
Sameera Ansari
No abstract text is available yet for this article.
July 19, 2018: International Journal of Integrated Care
Kasper Raus, Eric Mortier, Kristof Eeckloo
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...
July 11, 2018: International Journal of Integrated Care
Audhild Høyem, Deede Gammon, Gro Rosvold Berntsen, Aslak Steinsbekk
Introduction: In response to increase of patients with complex conditions, policies prescribe measures for improving continuity of care. This study investigates policies introducing coordinator roles in Norwegian hospitals that have proven challenging to implement. Methods: This qualitative study of policy documents employed a discourse analysis inspired by Carol Bacchi's 'What's the problem represented to be?'. We analysed six legal documents (2011-2016) and selected parts of four whitepapers presenting the statutory patient care coordinator and contact physician roles in hospitals...
July 10, 2018: International Journal of Integrated Care
Tony Brauer
While trying to represent patients in the design of integrated care, I have heard the words system, systemic and holism used frequently. Few of those using the words seem to be aware of the history of systems thinking, or its principles. Health interventions are instead designed using logic modelling, which is aholistic and disintegrative. This concern is illustrated in relation to the UK's Better Care Fund, which was an attempt to reduce hospital admissions by co-ordinating care. Systems thinking is then used to provide a possible distinction between three operating systems for the UK's National Health Service (NHS)...
July 10, 2018: International Journal of Integrated Care
Sam Pless, Geert Van Hootegem, Ezra Dessers
Introduction: Many care organisations claim to employ multidisciplinary teams, but the term is used to describe quite different forms of collaboration. A systemic view of the work organisation of care delivery is presented and applied in this article that allows to identify and understand often overlooked yet important differences regarding team composition, working relationships and therapeutic relationships. Theory and Methods: We used modern socio-technical systems theory to study care delivery for a particular patient population as a system of interrelated activities...
July 5, 2018: International Journal of Integrated Care
Kris Pui Kwan Ma, Anne Saw
Introduction: Integrating primary care and behavioural health services improves access to services and health outcomes among individuals with serious mental illness. Integrated care is particularly promising for racial and ethnic minority individuals given higher rates of chronic illnesses and poorer access to and quality of care compared to Whites. However, little is known about integrated care implementation in non-White populations. The aim of this study is to identify facilitators and barriers to successful implementation of primary care-behavioural health integration in a multilingual behavioural healthcare setting...
July 3, 2018: International Journal of Integrated Care
Matthias Mitterlechner, Céline Hollfelder, Joachim Koppenberg
Introduction: Many countries report difficulties in preserving access to care in rural areas. This paper examines how hard-to-serve regions sustain care provision by transforming service delivery into population health systems. Theory and methods: The paper builds on theory on care delivery in hard-to-serve regions. It presents a qualitative case study from the Lower Engadin, a rural high mountain valley in the Swiss Alps. Data sources include semi-structured interviews, participant observations, and documents...
July 3, 2018: International Journal of Integrated Care
John Eastwood
No abstract text is available yet for this article.
June 13, 2018: International Journal of Integrated Care
Scott J Fitzpatrick, David Perkins, Tonelle Handley, Dale Brown, Teresa Luland, Eamonn Corvan
Introduction: The 'GP Clinic' provides primary health care to people using community mental health services in a small town in Australia. This article examines the factors that have driven successful integration in this rural location. Methods: A multiple methods case study approach was used comprising service record data for a 24 month period and semi-structured interviews with sixteen staff members associated with the integrated rural service model. Results: Processes and structures for establishing integrated care evolved locally from nurturing supportive professional and organisational relationships...
June 5, 2018: International Journal of Integrated Care
Liliana Abreu, João Arriscado Nunes, Peter Taylor, Susana Silva
Background: Improvements in asthma integrated care might be achieved through in-depth knowledge about how health literacy is dispersed through a group. This study intends to map out health literacy mediators (those who makes his/her literacy skills available to others for them to accomplish specific literacy purposes) and how they enable self-management skills in patients with asthma. Methods: Twenty interviews were conducted in a Primary Care Center of Porto using the McGill Illness Narrative Interview...
June 5, 2018: International Journal of Integrated Care
Loraine Busetto, Katrien Luijkx, Stefano Calciolari, Laura Guadalupe González Ortiz, Hubertus Johannes Maria Vrijhoef
Introduction: The aim of the study is to investigate the barriers and facilitators to the implementation of workforce changes implemented as part of integrated chronic care interventions. Methods: We used a qualitative multimethod design that combined expert questionnaires, a systematic literature review, and secondary analysis of two case reports. Twenty-five experts, twenty-one studies and two case reports were included in the study. Results: Most barriers related to problematic delivery structures, health professionals' skills and enthusiasm, IT, funding, culture and cooperation and communication...
June 1, 2018: International Journal of Integrated Care
Francisco Hernansanz Iglesias, Clara Alavedra Celada, Carmen Berbel Navarro, Lidia Palau Morales, Nuria Albi Visus, Cristina Cobo Valverde, Vanessa Matias Dorado, Maria Luisa Martínez Muñoz, Carles Blay Pueyo, Esther Limón Ramírez, Raimon Milà Villaroel, Núria Montellà Jordana, Josep Maria Bonet Simó
Background: Chronicity, and particularly complex care needs for people with chronic diseases is one of the main challenges of health systems. Objective: To determine the population prevalence of people with chronic diseases and complex care needs and to characterize these needs considering features of health and social complexity in Primary Care. Design: Cross-sectional population-based study. Scope: Patients who have one or more chronic health conditions from three Primary Care urban centres of a reference population of 43...
May 25, 2018: International Journal of Integrated Care
Niamh Lennox-Chhugani
Integrated care requires joined up information for effective planning, delivery and management. Different countries are experimenting with a range policy approaches to designing integrated information systems with varying levels of success. Information systems to support integrated care that start with the needs of the user of information (individual, health and care professional, service manager, payer, policy maker), are most likely to succeed in being adopted. We suggest that using the MINDSPACE behavioural framework alongside technology tools to engage users in a process of co-design for integrated information systems will help deliver on the promise of better population health and better value healthcare sooner rather than later by producing information systems that support real time coordinated person- and community-centred decision-making...
May 22, 2018: International Journal of Integrated Care
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