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International Journal of Integrated Care

Nicolette Sheridan, Timothy Kenealy, Kerry Kuluski, Ann McKillop, John Parsons, Cecilia Wong-Cornall
INTRODUCTION: Patient self-management support is central to care for long term conditions and for integrated care. Patients and their carers are the final arbiter of whether support for self-management has been effective. A new taxonomy lists 14 categories of provider activities that support patient self-management (Practical Reviews in Self-Management Support, PRISMS). We asked whether we could recognise these provider activities in narratives from patients and carers. We sought to extend the theoretical framework of the taxonomy to include the view from patient and carers...
August 27, 2017: International Journal of Integrated Care
Lian Leng Low, Wei Yi Tay, Shu Yun Tan, Elian Hui San Chia, Rachel Marie Towle, Kheng Hock Lee
BACKGROUND: Organizing care into integrated practice units (IPUs) around conditions and patient segments has been proposed to increase value. We organized transitional care into an IPU (THC-IPU) for a patient segment of functionally dependent patients with limited community ambulation. METHODS: 1,166 eligible patients were approached for enrolment into THC-IPU. THC-IPU patients received a comprehensive assessment within two weeks of discharge; medication reconciliation; education using standardized action plans and a dedicated nurse case manager for up to 90 days after discharge...
August 14, 2017: International Journal of Integrated Care
Roberto Nuño-Solinís
Progress in health care integration is largely linked to changes in processes and ways of doing. These changes have knowledge management and learning implications. For this reason, the use of the concept of organisational learning is explored in the field of integrated care. There are very limited contributions that have connected the fields of organisational learning and care integration in a systematic way, both at the theoretical and empirical level. For this reason, hybridization of both perspectives still provides opportunities for understanding care integration initiatives from a research perspective as well as potential applications in health care management and planning...
August 11, 2017: International Journal of Integrated Care
Nigel King, Alison Bravington, Joanna Brooks, Jane Melvin, David Wilde
BACKGROUND: Collaborative working between professionals is a key component of integrated care. The academic literature on it largely focuses either on integration between health and social care or on the dynamics of power and identity between doctors and nurses. With the proliferation and extension of nursing roles, there is a need to examine collaborative working amongst different types of nurses. METHOD: This study explored experiences of collaborative working amongst generalist and specialist nurses, in community and acute settings...
August 10, 2017: International Journal of Integrated Care
Kerry Kuluski, Julia W Ho, Parminder Kaur Hans, Michelle LA Nelson
INTRODUCTION: A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care components to support complex patients and their families in the community. METHODS: Expert panel focus groups with 24 care providers, working in health and social care sectors across Toronto, Ontario, Canada were conducted...
July 21, 2017: International Journal of Integrated Care
Tomas Zapata, Norbert Forster, Pedro Campuzano, Rejoice Kambapani, Heena Brahmbhatt, Grace Hidinua, Mohamed Turay, Simon Kimathi Ikandi, Leonard Kabongo, Farai Zariro
INTRODUCTION: During the past two decades, HIV and Sexual and Reproductive Health services in Namibia have been provided in silos, with high fragmentation. As a consequence of this, quality and efficiency of services in Primary Health Care has been compromised. METHODS: We conducted an operational research (observational pre-post study) in a public health facility in Namibia. A health facility assessment was conducted before and after the integration of health services...
July 12, 2017: International Journal of Integrated Care
Maureen Rutten-van Mölken
No abstract text is available yet for this article.
June 28, 2017: International Journal of Integrated Care
Frank Hanson, Rhene Hanson
No abstract text is available yet for this article.
June 27, 2017: International Journal of Integrated Care
Kerry Kuluski, Nicolette Sheridan, Tim Kenealy, Mylaine Breton, Ann McKillop, Jay Shaw, Jason Xin Nie, Ross Eg Upshur, G Ross Baker, Walter P Wodchis
Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC) to better meet the needs of aging populations and their carers. Across the world CBPHC is at varying stages of evolution and no standard model exists. In order to scale up and spread successful models of care it is important to study what works well and why to support broader efforts to implement, scale-up and spread promising innovations. The first step in this endevour is to select appropriate cases to study...
June 27, 2017: International Journal of Integrated Care
Tim Tenbensel, Fiona Miller, Mylaine Breton, Yves Couturier, Frances Morton-Chang, Toni Ashton, Nicolette Sheridan, Alexandra Peckham, A Paul Williams, Tim Kenealy, Walter Wodchis
Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions...
June 27, 2017: International Journal of Integrated Care
Mylaine Breton, Carolyn Steele Gray, Nicolette Sheridan, Jay Shaw, John Parsons, Paul Wankah, Timothy Kenealy, Ross Baker, Louise Belzile, Yves Couturier, Jean-Louis Denis, Walter P Wodchis
The aim of this paper is to set the foundation for subsequent empirical studies of the "Implementing models of primary care for older adults with complex needs" project, by introducing and presenting a brief descriptive comparison of the nine case studies in Quebec, Ontario and New Zealand. Each case is described based on key dimensions of Rainbow model of Valentijn and al (2013) with a focus on "meso level" integration. Meso level integration is represented by organizational and professional elements of the Rainbow Model, which are of particular interest in our nine case studies...
June 27, 2017: International Journal of Integrated Care
Cecilia Wong-Cornall, John Parsons, Nicolette Sheridan, Timothy Kenealy, Allie Peckham
BACKGROUND: Family carers, as a "shadow workforce", are foundational to the day-to-day integration of health service delivery for older family members living with complex health needs. This paper utilises Haggerty's model of continuity of care to explore the contribution of family carers' to the provision of care and support for an older family member's chronic condition within the context of health service delivery. METHODS: We analysed data from interviews of 13 family carers in a case study of primary health care in New Zealand - a Maori Provider Organisation - to determine the alignment of family caregiving with the three levels of continuity of care (relational continuity, informational continuity, and management continuity)...
June 27, 2017: International Journal of Integrated Care
Ann McKillop, Jay Shaw, Nicolette Sheridan, Carolyn Steele Gray, Peter Carswell, Walter P Wodchis, Martin Connolly, Jean-Louis Denis, G Ross Baker, Timothy Kenealy
INTRODUCTION: Many studies have investigated the process of healthcare implementation to understand better how to bridge gaps between recommended practice, the needs and demands of healthcare consumers, and what they actually receive. However, in the implementation of integrated community-based and integrated health care, it is still not well known which approaches work best. METHODS: We conducted a systematic review and metanarrative synthesis of literature on implementation frameworks, theories and models in support of a research programme investigating CBPHC for older adults with chronic health problems...
June 27, 2017: International Journal of Integrated Care
Jenna M Evans, Agnes Grudniewicz, Carolyn Steele Gray, Walter P Wodchis, Peter Carswell, G Ross Baker
INTRODUCTION: The variable success of integrated care initiatives has led experts to recommend tailoring design and implementation to the organizational context. Yet, organizational contexts are rarely described, understood, or measured with sufficient depth and breadth in empirical studies or in practice. We thus lack knowledge of when and specifically how organizational contexts matter. To facilitate the accumulation of evidence, we developed a research toolkit for conducting case studies using standardized measures of the (inter-)organizational context for integrating care...
June 27, 2017: International Journal of Integrated Care
Kris Van den Broeck, Frédéric Ketterer, Roy Remmen, Marc Vanmeerbeek, Marianne Destoop, Geert Dom
Although current guidelines recommend collaborative care for severely depressed patients, few patients get adequate treatment. In this study we aimed to identify the thresholds for interdisciplinary collaboration amongst practitioners when treating severely depressed patients. In addition, we aimed to identify specific and feasible steps that may add to improved collaboration amongst first and second level Belgian health care providers when treating depressed patients. In two standard focus groups (n = 8; n = 12), general practitioners and psychiatrists first outlined current practice and its shortcomings...
June 21, 2017: International Journal of Integrated Care
Inge C Boesveld, Pim P Valentijn, Marit Hitzert, Marieke A A Hermus, Arie Franx, Raymond G de Vries, Therese A Wiegers, Marc A Bruijnzeels
INTRODUCTION: Integrated care is considered to be a means to reduce costs, improve the quality of care and generate better patient outcomes. At present, little is known about integrated care in maternity care systems. We developed questionnaires to examine integrated care in two different settings, using the taxonomy of the Rainbow Model of Integrated Care. The aim of this study was to explore the validity of these questionnaires. METHODS: We used data collected between 2013 and 2015 from two studies: the Maternity Care Network Study (634 respondents) and the Dutch Birth Centre Study (56 respondents)...
June 20, 2017: International Journal of Integrated Care
Daniel Schlieper, Christiane Altreuther, Manuela Schallenburger, Martin Neukirchen, Andrea Schmitz, Christian Schulz-Quach
INTRODUCTION: The Liverpool Care Pathway for the Dying Patient is an instrument to deliver integrated care for patients in their last hours of life. Originally a paper-based system, this study investigates the feasibility of an electronic version. METHODS: An electronic Liverpool Care Pathway was implemented in a specialized palliative care unit of a German university hospital. Its use is exemplified by means of auditing and analysis of the proportion of recorded items...
June 20, 2017: International Journal of Integrated Care
Salvador Tortajada, María Soledad Giménez-Campos, Julia Villar-López, Raquel Faubel-Cava, Lucas Donat-Castelló, Bernardo Valdivieso-Martínez, Elisa Soriano-Melchor, Amparo Bahamontes-Mulió, Juan M García-Gómez
In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit...
June 20, 2017: International Journal of Integrated Care
Wenxi Tang, Lai Wei, Liang Zhang
INTRODUCTION: China's organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS) provides a new perspective and methodology for analysing the health system and policy implementation...
June 19, 2017: International Journal of Integrated Care
Yu Hatano, Masatoshi Matsumoto, Mitsuaki Okita, Kazuo Inoue, Keisuke Takeuchi, Takako Tsutsui, Shuhei Nishimura, Takuo Hayashi
INTRODUCTION: Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities. METHODS: This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system...
April 27, 2017: International Journal of Integrated Care
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