International Journal of Integrated Care最新文献

{"title":"Implementation and Evaluation of an Integrated Care Team for Refugee Health: A Case Study in Ontario, Canada.","authors":"Catherine E Tong, Alexandra Whate, Wajma Attayi, Debbie Engel, Paul Stolee","doi":"10.5334/ijic.9815","DOIUrl":"10.5334/ijic.9815","url":null,"abstract":"<p><strong>Background: </strong>Refugees face significant barriers in accessing primary care, often resulting in poorer health outcomes. This case study evaluates the implementation of a multidisciplinary Integrated Care Team (ICT) for refugees, in Ontario, Canada. The aim of the ICT was to transition refugees into primary care practices.</p><p><strong>Methods: </strong>A mixed-methods process evaluation was conducted to assess the implementation and outcomes of the ICT program. Data sources included ethnographic observations, in-depth interviews with ICT staff, clinicians, and refugee patients. Thematic analysis was applied to qualitative data, and program database metrics were analyzed to evaluate patient transitions and service use.</p><p><strong>Findings: </strong>In its first year, the ICT transitioned 664 refugees to primary care, surpassing its goal of 300. Key successes included improved collaboration, enhanced system navigation, and reduced pressure on refugee clinics. Refugee participants reported feeling supported through the ICT program, emphasizing the importance of personalized care and assistance in navigating the healthcare system. The program improved access to primary care, facilitated timely referrals, and addressed social determinants of health.</p><p><strong>Discussion: </strong>The ICT program demonstrates the potential of integrated care to enhance refugee health outcomes. Flexibility, collaboration, and proactive support were essential to its success. Future research should explore long-term impacts and scalability.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 3","pages":"4"},"PeriodicalIF":2.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Digital Screening and Navigation Model in Addressing Unmet Social Needs among Parents and Caregivers in Priority Population Groups: A Randomised Controlled Trial.","authors":"Teresa Winata, James John, Si Wang, Melissa Smead, Weng Tong Wu, Jane Kohlhoff, Virginia Schmied, Bin Jalaludin, Kenny Lawson, Siaw-Teng Liaw, Raghu Lingam, Andrew Page, Christa Lam-Cassettari, Katherine Boydell, Ping-I Lin, Ilan Katz, Ann Dadich, Shanti Raman, Rebekah Grace, Aunty Kerrie Doyle, Tom McClean, Blaise Di Mento, John Preddy, Susan Woolfenden, Valsamma Eapen","doi":"10.5334/ijic.9228","DOIUrl":"10.5334/ijic.9228","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Children and families from priority populations (e.g. culturally and linguistically diverse and regional/rural communities) often experience significant psychosocial challenges and barriers to accessing health and social care. These inequities were further exacerbated during the COVID-19 pandemic. Integrating social care with health services has been proposed as an approach to improve service access and address unmet needs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A two-site parallel randomised controlled trial was conducted in Australia between August 2021 and 2023. Parents/carers of children from priority populations were recruited through Child and Family Health services (n = 288) and randomised to the Watch Me Grow-Electronic (WMG-E) intervention (n = 145) or care as usual (n = 143). The WMG-E program comprised digital developmental screening and community navigation to relevant health and social services via a service navigator. The primary outcome was change in unmet social needs measured using the WE CARE instrument. Intention-to-treat generalised linear mixed-effects models adjusted for child developmental concerns, parental mental health, and sociodemographic factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Unmet social needs decreased over time across both groups (β = -0.23, SE = 0.11, p = 0.036). At 12 months, the intervention group showed greater reductions in unmet needs than the control group (β = -0.35, SE = 0.17, p = 0.046), although the time × group interaction was not significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The WMG-E platform demonstrated feasibility as a digital developmental screening and navigation tool supporting families from priority populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;WMG-E shows promise in improving access to health and social care and reducing unmet social needs; however, further research is needed to assess sustained impacts across diverse settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The study (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21&lt;sup&gt;st&lt;/sup&gt; 2021, and the trial results are being reported according to recommendations in the CONSORT Statement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary box: &lt;/strong&gt;&lt;b&gt;What is already known on this topic&lt;/b&gt; Significant inequities exist in the access to healthcare for priority population families with preschool children and this results in children missing opportunities for early identification and intervention for health and developmental problems.While addressing heath care inequities is critical for providing children a healthy start to life, there are no effective and systematic ways to reach such families as they do not engage with services early, and often experience significant barriers due to social care needs.Addressing health inequities by tackling social determinants of health alongside healthcare is critical to supporting families in priority population groups, aligning with t","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 3","pages":"2"},"PeriodicalIF":2.7,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Study on the Integrated Healthcare Delivery System in Xuhui District, Shanghai Best Practices and Implementation.","authors":"Yanjun Huang, Gan Wang, Rong Chen, Biao Wang, Xinyu Li, Qiong Zhu, Zhijie Yu","doi":"10.5334/ijic.9812","DOIUrl":"10.5334/ijic.9812","url":null,"abstract":"<p><strong>Background: </strong>The \"Six-Bed Integration\" model in Kangjian Subdistrict, Shanghai, represents an innovative approach to integrated eldercare, combining three healthcare beds (family medical beds, rehabilitation/palliative care beds, and hospital beds) with three eldercare beds (home care, day care, and institutional care). This study explores the implementation challenges and systemic tensions within this model.</p><p><strong>Methods: </strong>Using purposive sampling, professionals (N = 15) involved in the Kangjian integrated care system were interviewed through semi-structured interviews. Data were analyzed via Colaizzi's phenomenological approach to identify key themes.</p><p><strong>Results: </strong>The study identified three key challenges in the integrated care model: (1) Structural barriers including Medicare restrictions, bed shortages, and unclear admission criteria hindered service integration; (2) Ineffective outreach to homebound seniors and digital disparities limited service accessibility and understanding; (3) Unclear stakeholder responsibilities caused referral disputes, with nursing homes rejecting high-risk cases and discharge-bed availability mismatches worsening conflicts. These findings reveal systemic gaps in resource allocation, communication, and coordination within the integrated care system.</p><p><strong>Conclusion: </strong>The \"Six-Bed Integration\" model demonstrates potential in bridging medical and social care but faces challenges in resource allocation, communication, and inter-institutional accountability. The study implies that optimizing integrated care delivery requires not only frontline training in coordination skills but also policy support to create synergistic mechanisms for resource sharing and accountability. Policy interventions must address Medicare constraints, standardize referral protocols, and enhance cross-sector collaboration to optimize integrated eldercare delivery.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 3","pages":"3"},"PeriodicalIF":2.7,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Team Composition on Integrated Care Within Multidisciplinary Family Doctor Teams in China: Inter-Professional Collaboration as Mediator.","authors":"Yanli Shi, Ganquan Yu, Huilan Zhou, Yushan Ke, Jindi Wen, Xin Wang","doi":"10.5334/ijic.9837","DOIUrl":"10.5334/ijic.9837","url":null,"abstract":"<p><strong>Introduction: </strong>Integrated care (IC) is pivotal to China's primary healthcare reform under Healthy China 2030. Multidisciplinary family doctor teams (FDTs), with variable compositions, aim to deliver IC but face performance inconsistencies. While prior studies associate team composition with clinical outcomes, they neglect to elucidate the underlying mediating mechanisms. This study examines the association between FDT composition and IC, and whether inter-professional collaboration (IPC) may act as a mediator in this relationship.</p><p><strong>Methods: </strong>This cross-sectional study surveyed 224 stratified-randomly sampled FDTs in Guangzhou in August 2023. Validated instruments were used to measure IPC and IC. We evaluated the potential mediating role of IPC using bias-corrected bootstrap procedures, and conducted a path analysis to explore the associations between IPC and IC.</p><p><strong>Results: </strong>For standard teams compared with basic teams, the total effect on IC was not significant (B = 1.986, 95% CI: -0.719 to 4.691). The indirect effect via IPC was significant (B = 1.743, 95% CI: 0.490 to 3.128), while the direct effect was not significant (B = 0.243, 95% CI: -2.157 to 2.643). For advanced teams, the total effect was significant (B = 7.386, 95% CI: 4.316 to 10.456). Both the direct effect (B = 5.351, 95% CI: 2.624 to 8.077) and the indirect effect via IPC (B = 2.035, 95% CI: 0.548 to 3.492) were significant. Path analysis further examined the structural associations between IPC and the multifactorial components of IC.</p><p><strong>Conclusion: </strong>For advanced teams, team composition was positively associated with IC, with IPC partially mediating this relationship. For standard teams, only the indirect effect via IPC was significant.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 3","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrated Work-Oriented Care Model Using Key Elements of the International Classification of Functioning and the Capability Approach.","authors":"Desiree J S Dona, Suzanne E J Kaal, Bart P A Thoonen, Patrick Jeurissen, Frederieke G Schaafsma","doi":"10.5334/ijic.10270","DOIUrl":"10.5334/ijic.10270","url":null,"abstract":"<p><p>Addressing the impact of chronic conditions on work participation requires an integrated care model that embeds work-related goals from diagnosis onward. The Work-oriented Care Model (WoCM) adopts a biopsychosocial, patient-centered approach and incorporates key elements of the Capability Approach (CA) and the International Classification of Functioning (ICF), aligning functional performance with individual goals and contextual factors. A case study illustrates the need for continuous work-oriented assessment involving healthcare and occupational professionals. Implementation challenges underscore the importance of structural integration and improved coordination across healthcare and occupational systems.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 2","pages":"23"},"PeriodicalIF":2.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned from Providing Integrated Care Within an Interprofessional Learning and Innovation Network in the Community.","authors":"Petra Boersma, Lilian Linders, Henk L G R Nies, Robbert J J Gobbens","doi":"10.5334/ijic.9122","DOIUrl":"10.5334/ijic.9122","url":null,"abstract":"<p><strong>Introduction: </strong>The Interprofessional Learning and Innovation Network (IP-LIN), comprising nursing and social care professionals, students, and teachers, was established to enhance integrated care competences, specifically attention to health and wellbeing for older adults living in the community.</p><p><strong>Description: </strong>This case study with ten interprofessional case discussions and two focus groups was completed with nursing and social work professionals, students and teachers. Thematic analysis regarding five interprofessional competences of the Zuyd Interprofessional Building Blocks model was conducted. Key recurring themes included responsibility, available time, mutual understanding of professional language, reflection on attitudes, and optimising client autonomy. Identified barriers were the absence of a joint care plan, incomplete application of the methodical circle, and insufficient consultation among professionals involved with the client.</p><p><strong>Discussion: </strong>Participants recognised that interprofessional learning fosters improved collaboration between nursing and social work domains; however, the absence of a joint care plan remains a significant obstacle to fully integrated care.</p><p><strong>Conclusion: </strong>The IP-LIN facilitated opportunities for professionals, students, and teachers to understand each other's roles, responsibilities, and perspectives, thereby increasing confidence in interprofessional and team competencies. Successful IP-LIN implementation requires sustained commitment from both care and social work sectors to overcome existing barriers and promote integrated care.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 2","pages":"22"},"PeriodicalIF":2.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation Determinants of Integrated Tuberculosis and Diabetes Care in South Asian Association for Regional Cooperation (SAARC) Countries: A Systematic Review.","authors":"Saima Aleem, Saima Afaq, Suneel Gill, Bilal Ahmad, Zunaira Michael, Rida Zarkaish, Zohaib Khan","doi":"10.5334/ijic.9882","DOIUrl":"10.5334/ijic.9882","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) and diabetes mellitus (DM) represent a growing syndemic in low- and middle-income countries (LMICs), particularly across South Asia. The bidirectional relationship between these diseases exacerbates health outcomes and increases system burdens. Although the World Health Organization has advocated for integrated management of TB and DM, implementation remains inconsistent across the SAARC region. This systematic review aims to identify and analyse implementation determinants of integrated TB and DM care in SAARC countries.</p><p><strong>Methods: </strong>We conducted a systematic review following PRISMA 2020 guidelines. searching MEDLINE (via Ovid), EMBASE, Web of Science, Cochrane CENTRAL, and CINAHL for peer-reviewed studies. Grey literature was sourced from Google Scholar and citation search. Four reviewers independently screened title, abstract and full text using Rayyan. Using a structured Excel form, two reviewers extracted data. Quality assessment was conducted by using Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was conducted in line with SWiM guidelines to categorize implementation determinants as barriers or facilitators.</p><p><strong>Results: </strong>Ten studies met the inclusion criteria and were conducted across five SAARC countries: India (n = 7), Pakistan (n = 1), Bangladesh (n = 1), and Sri Lanka (n = 1). Identified facilitators included political commitment, use of digital tools, and training of healthcare workers. Barriers encompassed inadequate infrastructure and finances, workforce shortages, lack of standardized guidelines and fragmented vertical health systems.</p><p><strong>Conclusion: </strong>Integrated TB-DM care in the SAARC region remains at an early developmental stage, with most efforts limited to pilot projects or small-scale screenings. Despite political and institutional recognition of the dual burden, scale-up is constrained by systemic barriers, resource gaps, and lack of evidence-informed implementation strategies. Future efforts should prioritize system-wide integration guided by implementation frameworks, standardized protocols, and investment in workforce and infrastructure to achieve sustainable impact.</p><p><strong>Systematic review registration: </strong>PROSPERO registration number: CRD42025644263.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 2","pages":"21"},"PeriodicalIF":2.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Dependence in Everyday Life- a Qualitative Study of Older Adults and Relatives' Experiences of the Post-Discharge Home-Based Follow-Up Visit.","authors":"Sanne Have Beck, Astrid Janssens, Grethe Eilertsen, Karen Andersen-Ranberg, Dorthe Susanne Nielsen","doi":"10.5334/ijic.9822","DOIUrl":"10.5334/ijic.9822","url":null,"abstract":"<p><strong>Introduction: </strong>When older adults living with multimorbidity are hospitalised, they often require the involvement of multiple stakeholders to ensure continuity of care when transitioning from hospital to home. More interventions have been examined. This study aimed to explore how older adults and their relatives, spouses, or adult children experienced a nurse-led, cross-sectoral home-based follow-up visit after hospital discharge.</p><p><strong>Methods: </strong>This study is grounded in critical psychological practice research. We conducted qualitative individual and family semi-structured interviews with 10 older adults, six relatives, three spouses, and three adult children. The interviews were conducted by telephone or face-to-face. The analysis was inspired by Braun and Clarke.</p><p><strong>Results: </strong>We identified three themes: 1) Cross-sectoral home-based follow-up visit - an experience of caring and competent nurses, 2) Navigating dependency and disruption - balancing a new situation, and 3) Relatives - caught between support and caregiver burden.</p><p><strong>Conclusion: </strong>The cross-sectoral, home-based follow-up visit was considered important by some older adults and all relatives during the transition from hospital to home, as it enhanced their sense of safety. The integration of care across healthcare settings improved cross-sectoral communication, facilitated collaboration across care settings, and ensured the secure transfer of information and mutual knowledge translation.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 2","pages":"20"},"PeriodicalIF":2.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Care in the Heart of the Moment - Exploring the Process of Collaboration for the Making of Flexible Assertive Community Treatment.","authors":"Ulrika Bejerholm, Daniel Lindqvist, Sofie Westling, Elisabeth Argentzell, Annika Lexén, Marcus Knutagård","doi":"10.5334/ijic.9832","DOIUrl":"10.5334/ijic.9832","url":null,"abstract":"<p><strong>Introduction: </strong>Professional and organisational collaboration of integrated services, like Flexible Assertive Community Treatment (FACT), plays a pivotal role in ensuring continuous and coordinated care for persons with complex mental health needs. While some research reflect team members' view of FACT or program fidelity, no research has explored the social practice of FACT and how collaboration evolve and sustain.</p><p><strong>Aim: </strong>The aim is to explore the process of collaboration for the making of the integrated service of FACT.</p><p><strong>Methods: </strong>A constructivist grounded theory design helped to collect and analyse empirical evidence of 28 interviews with multiprofessional FACT team members and managers, in 2021 (n = 14) and 2022/2023 (n = 14) in Sweden.</p><p><strong>Results: </strong><i>Building care in the heart of the moment</i> was constructed as the core category reflecting the timely process of FACT, while the sub-categories of 1) <i>Embracing empathy and holistic view with users' best interest at heart</i>, 2) <i>Openness, curiosity and genuine interest for each other</i>, 3) <i>Borders across disciplines and services get erased yet sharpened</i>, and 4) <i>Orchestration of the team and leadership underpins sustainable collaboration</i> reflected critical ingredients and passages of collaboration.</p><p><strong>Discussion: </strong>Sustainable collaboration required organisations to support team members' transition from individual or entrapped social niches into an enabling niche, supportive team environment. Cultivating a social learning space may reduce uncertainty and enables timely, skillful action through which relationships, expertise, and performance develop.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 2","pages":"19"},"PeriodicalIF":2.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Practitioners' Experiences of Implementing Frailty Same Day Emergency Care: A Researcher-in-Residence Study.","authors":"Kieran Green, Sheena Asthana, John Downey, Joanne Watson","doi":"10.5334/ijic.9854","DOIUrl":"10.5334/ijic.9854","url":null,"abstract":"<p><strong>Introduction: </strong>NHS policy promotes Frailty Same Day Emergency Care (F-SDEC) units to alleviate pressure on emergency departments (ED) and improve care for frail people through comprehensive geriatric assessment and same-day discharge. However, evidence remains limited on how such services are implemented in practice, particularly in resource-constrained and geographically peripheral settings. This study aimed to examine how implementation barriers are experienced and negotiated during the day-to-day delivery of an F-SDEC pilot.</p><p><strong>Methods: </strong>Using a Researcher-in-Residence approach, a researcher embedded in a coastal hospital in Torbay, South-West England, collected field notes from prior observations to inform the interview guide, conducted semi-structured interviews with staff delivering F-SDEC, and held a feedback session. A framework-informed, reflexive thematic approach guided the identification of key implementation challenges and enablers.</p><p><strong>Results: </strong>Staff viewed F-SDEC as beneficial for improving care for older adults, but interacting barriers constrained implementation. ED-based triage was time-intensive and difficult to routinise due to fragmented, non-interoperable IT systems, inconsistent understanding of frailty across hospital teams, and shifting eligibility criteria. Operational pressures, workforce and skill-mix shortages, and an inconsistent understanding of F-SDEC's needs and purpose also limited CGA delivery and contributed to day-to-day variability in throughput. While staff expressed a desire to reorient towards community-based referrals, the same digital and workforce constraints also limited the feasibility of alternative routes, further raising sustainability concerns.</p><p><strong>Conclusions: </strong>F-SDEC implementation was shaped by interdependent system constraints rather than isolated barriers. In peripheral and resource-constrained settings, successful implementation may depend on whole-system alignment across digital infrastructure, workforce capacity, and cross-team collaboration, with national policy better accounting for local delivery conditions.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"26 2","pages":"18"},"PeriodicalIF":2.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}