{"title":"Continuity drives care coordination","authors":"H. Vrijhoef","doi":"10.1177/20534345231159949","DOIUrl":"https://doi.org/10.1177/20534345231159949","url":null,"abstract":"In its practice brief on the continuity and coordination of care, the World Health Organisation (WHO) points out that “continuity enables care coordination by creating the conditions and ongoing relationships to support seamless interactions among multiple providers, within interdisciplinary teams or in care settings or sectors.” By presenting the results chain or the hierarchy of contributions that may be anticipated from a package of interventions and processes to deliver the desired outcomes, it becomes clear that for the design, implementation, and evaluation of care coordination, one should include continuity of care and vice versa. Not doing so, or looking at one concept without the other, would easily result in an oversimplification and misunderstanding of both concepts. Moreover, acknowledging that for achieving continuity and coordination of care a range of approaches and interventions is needed, neither continuity of care nor coordination of care should be understood as a simple intervention. Instead, both are complex in nature and nested in a broader strategy. To better understand continuity and coordination of care there is a need for theory-based evaluation of these related concepts. The scarcity of such evaluation and research efforts is mentioned by WHO in the practice brief. The International Journal of Care Coordination welcomes (more) high-quality, theory-based research including the application of approaches, such as Theory of Change and Realist Research, when studying or evaluating continuity and coordination of care. This approach to research enables us to better understand why continuity and coordination of care works (or not), how, for whom, and when. Answers to these questions are of increasing importance with complex strategies for continuity and coordination of care getting adopted in different contexts. Mixed methods research combining qualitative and quantitative data collection and analysis is at the heart of theory-based research. In the current issue of the International Journal of Care Coordination studies are reported that include either qualitative or quantitative data. The first paper presents a synthesis of social workers coordination activities for patients with complex needs in primary healthcare. In their scoping review, Couturier et al. shed light on the significant role social workers play in care coordination with the aim to support aligning the work of social workers with that of other professionals in primary care. Notwithstanding interprofessional collaboration is common in practice, the authors mention it is rarely supported by training and hence recommend further attention to the education and training of social workers to enable them to act effectively in care coordination and team-based care delivery. Kokorelias et al. examined the challenges associated with supporting low-income seniors as they transition from hospital to home and explored what role, if any, patient navigation models of care shoul","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46603480","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}
{"title":"Preparing students for interprofessional collaboration in services for children with special needs in Finland: A document analysis","authors":"Hanna Kallio, Jaanet Salminen, Miia Tuominen","doi":"10.1177/20534345231153813","DOIUrl":"https://doi.org/10.1177/20534345231153813","url":null,"abstract":"Introduction Multiple types of support and expertise are needed for the benefit of children with special needs, with the collaboration between psychologists, social workers and special education teachers playing a key role. Here, we studied the extent of their academic training in interprofessional collaboration. Methods A document analysis of 24 curricula with 1699 courses from eight Finnish universities was applied. The courses focused on interprofessional collaboration were selected for the analysis. The course information was analysed with descriptive statistical methods, content analysis and qualitative quantification. Results A total of 38 courses focused on interprofessional collaboration. The courses were often mandatory; however, in psychology, they were often optional. The content of the courses included the basis of interprofessional collaboration, collaboration skills, and service systems and network familiarity. Two courses were common for the social work, psychology and special education programmes. Various learning methods were used, with five courses being based on independent online self-study. Discussion Considering the need for studies focusing on interprofessional collaboration, it was contradictory that these were largely maintained within one discipline and some were realised as independent self-studies. The variability of the curricula may reflect on students’ professional skills. For the collaboration of professionals working with children with special needs, it is also needed to deepen familiarity with cross-sectional services and the school system.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41734530","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}
Kristina M. Kokorelias, Christine L Sheppard, Sander L. Hitzig
{"title":"The role of patient navigation in supporting low-income older adults in their housing needs during hospital to home transitions: A qualitative descriptive study from Ontario, Canada","authors":"Kristina M. Kokorelias, Christine L Sheppard, Sander L. Hitzig","doi":"10.1177/20534345231151209","DOIUrl":"https://doi.org/10.1177/20534345231151209","url":null,"abstract":"Introduction Housing is an important determinant of health. Little research has explored hospital and community agency staff perspectives on how to support the housing needs of low-income older adults. Therefore, this paper examines the challenges associated with supporting low-income seniors as they transition from hospital to home and explores what role, if any, patient navigation models of care could have in addressing housing needs. Methods A thematic secondary analysis that triangulated data from two qualitative studies was used. In total, interviews and/or focus groups with 109 hospital and community care workers were re-analyzed, applying a new interpretive lens to the data to reveal new insights. Data were collected in Ontario, Canada. Results Participants described how low-income older adults have increasing complex care needs that influence their housing, but housing supports are limited and difficult to navigate. Participants believed further support was needed and suggested that a housing-specific patient navigation model of care may be beneficial, but difficult to implement due to the limitations of existing services. Discussion Our findings provide a unique perspective on the challenges hospital and community staff face in caring for older adults with housing needs. Patient navigation with a focus on housing may support these older adults. Further work needs to be undertaken to better understand how to best implement sustainable housing patient navigation models of care.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49241641","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}
{"title":"Understanding implementation characteristics in navigation programs for persons living with dementia and their caregivers: A scoping review","authors":"Kristina M. Kokorelias, Zoe Liu, Sander L. Hitzig","doi":"10.1177/20534345231151208","DOIUrl":"https://doi.org/10.1177/20534345231151208","url":null,"abstract":"Introduction Dementia care is often fragmented and un-coordinated. As the number of individuals living with dementia increases worldwide, navigation programs are a way to help counter difficulties with navigating and accessing services by better integrating care for individuals with dementia and their family caregivers. While navigation programs are increasingly being used, it is not clear how to best implement such programs in North America and abroad. Methods Following Arskey and O’Malley's (2006) scoping review methodology and theoretically informed by the Consolidated Framework for Implementation Research, this paper explored existing navigational programs used in dementia care to identify factors to consider when implementing these programs across different settings. Results Twenty-two articles were included in this review. Our findings suggest that there is a high degree of variability with how navigation programs are being delivered and no clearly established or standardized protocol to implement such programs. Barriers and facilitators to implementation were identified as they relate to (1) Complexity (Intervention Characteristics); (2) Patient and Caregiver Needs (Outer Setting); (3) External Policies (Outer Setting); (4) Available Resources (Inner Setting) (5) Communication (Inner Setting); (6) Culture (Inner Setting); (7) Leadership Engagement (Inner Setting); (8) Knowledge and Beliefs ( Characteristics of Individuals); (9) Champions (Process) and (10) Evaluation (Process). Discussion Combined, the findings from this review provide suggestions for implementing navigation in the context of dementia care and suggest several pragmatic considerations (e.g. available resources) when implementing new navigation programs.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136039624","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}
{"title":"Prematurity, birth weight, and access to a medical home among school-aged children in the US: A cross-sectional survey","authors":"Jessica Eubanks, Dmitry Tumin, Leslie Peedin","doi":"10.1177/20534345231151222","DOIUrl":"https://doi.org/10.1177/20534345231151222","url":null,"abstract":"Introduction Prematurity and low birth weight (LBW) are associated with higher health care needs and higher health care utilization in the first few years of life. The aim of this cross-sectional study was to determine how prematurity and LBW were correlated with access to a medical home later in childhood, at ages 6–17 years. Methods Data were analyzed from the 2016–2018 National Survey of Children's Health. Non-institutionalized US children 6–17 years of age who had been born preterm were classified as very low birth weight (VLBW, <1500 g), LBW (1500–2500 g), and normal weight (NBW, >2500 g). Term-born NBW children were included as a reference group. Medical home access was determined according to caregiver report. Results The analysis included 64,597 infants (preterm VLBW n = 737; preterm LBW n = 2869; preterm NBW n = 3942; and term NBW n = 57,049). Based on this sample, 44% of children ages 6–17 years were estimated to receive care meeting the criteria of a medical home. On multivariable analysis, none of the preterm groups had higher likelihood of receiving care in a medical home compared to children born at term and NBW (odds ratios ranging from 0.75 to 0.95). Conclusions School-aged children born preterm and LBW were equally or less likely to receive care meeting the criteria of a medical home than children born at term and NBW. Although prematurity and LBW are associated with increased health care use early in the life course, this does not appear sufficient to help children establish and maintain access to a medical home.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48038354","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}
{"title":"Predictive factors on caregiver burden in caregivers of individuals with cognitive impairment","authors":"Mijung Lee, Ishan C. Williams","doi":"10.1177/20534345221148281","DOIUrl":"https://doi.org/10.1177/20534345221148281","url":null,"abstract":"Introduction Informal caregivers, mostly family members or friends, have often been required to engage in medical/nursing tasks and to navigate complex healthcare systems. It is unclear whether those activities impact caregiver burden. Therefore, the purpose of this study was to examine predictive factors of caregiver burden in consideration of healthcare-related factors (caregivers’ perception of performing medical/nursing tasks, care coordination, and number of hospitalizations). Methods Secondary analysis of cross-sectional survey data taken from the Caregiving in the U.S. 2015 was conducted. Data were collected by the National Alliance for Caregiving and the American Association of Retired Persons (AARP). Self-identified caregivers (n = 304) who provided care for individuals with cognitive impairment (ICI), and who were living in the community were participants in the study. Results The overall model explained 38.4% of the variance in caregiver burden (F = 20.48, p < 0.001). When examining each factor, perceived difficulty in medical/nursing tasks (β = 0.38, p < 0.001) was the most influential factor, followed by caregivers’ physical health (β = −0.27, p < 0.001), income (β = −0.13, p = 0.01), and level of the care coordination (β = 0.12, p = 0.02). Discussion Although caregivers’ involvement in healthcare-related activities for ICI is necessary, this involvement has a considerable impact on caregiver burden. Healthcare providers should be cognizant of caregiver burden related to healthcare-related activities. Moreover, researchers should develop interventions and community services to decrease caregivers’ difficulty in performing their roles.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42537451","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}
{"title":"Healthy ageing and longevity","authors":"H. Vrijhoef","doi":"10.1177/20534345221133162","DOIUrl":"https://doi.org/10.1177/20534345221133162","url":null,"abstract":"‘As individual life spans have increased, the years of unhealthy life have also increased. Very few countries have made significant progress to prepare financially, socially, and scientifically for longer and healthier life spans’. In his foreword, Victor Dzau, president of the National Academy of Medicine (NAM), clearly describes we need to do much better in mitigating the challenges posed by the global ageing population. An independent international commission of experts was installed by the NAM to better understand these challenges and to identify effective solutions and recommendations for healthy ageing and longevity that can be applicable to diverse societies worldwide. The commission produced a roadmap of strategies related to social and behavioural enablers of health, healthcare and public health systems, and science and technology. Focusing on healthcare, the commission contends that a number of structures need to be established for healthcare systems to promote longevity, including:","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48976389","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}
Ni Luh Putu Lusiana Devi, I. Swarjana, N. P. J. Sastamidhyani, I. Wicaksana
{"title":"The nurse anesthetist’s perception of the role of case manager in four provinces of Indonesia","authors":"Ni Luh Putu Lusiana Devi, I. Swarjana, N. P. J. Sastamidhyani, I. Wicaksana","doi":"10.1177/20534345221124382","DOIUrl":"https://doi.org/10.1177/20534345221124382","url":null,"abstract":"Introduction Integrated and patient-focused healthcare is urgently needed, and there is an important role for case managers in implementing them. However, the understanding of healthcare providers, especially nurse anesthetists, about the role of case managers is still varied and is often considered only as a complement to hospital accreditation. This study aimed to determine the factors that influence the nurse anesthetist’s perception of the role of the case manager. Methods This cross-sectional study involved 369 nurse anesthetists who were selected using cluster sampling. Data collection was done using Google Forms. Furthermore, the data were analyzed using multiple logistic regression to identify the factors that influence the nurse anesthetists’ perception of the role of the case manager. Results From a total of 369 respondents, most (60%) have a positive perception of case managers. Marital status (AOR = 2.3; 95% CI: 1.27–4.15) and knowledge (AOR = 3.2; 95% CI: 2.03–5.07) were significant predictors of the nurse anesthetist’s perception of the role of the case manager. Discussion Even though the majority of nurse anesthetists have positive perceptions, socialization to increase knowledge about case managers is needed to reduce misperceptions about the role of case managers.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46196675","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}
Paul Killie, Rita Jakobsen, Kari Sørensen, J. Debesay
{"title":"A qualitative study of purchaser unit employees’ experiences of patient pathways from specialist healthcare to primary healthcare in Norway","authors":"Paul Killie, Rita Jakobsen, Kari Sørensen, J. Debesay","doi":"10.1177/20534345221124711","DOIUrl":"https://doi.org/10.1177/20534345221124711","url":null,"abstract":"Introduction Understanding the purchaser–provider split model in the patient pathway is important. The purchaser is a key player in managing the flow between specialist and municipal healthcare services. A smoother patient transfer has been a priority in Norway, but also challenging. Accordingly, this study aims to describe and explain how the purchasers operate as liaisons during patient transfers from specialist to primary healthcare services. Methods Eleven interviews were conducted with employees at purchaser units in primary healthcare in Norway. The interviewees’ professional backgrounds were in nursing and physiotherapy, as well as casework, and management. The interviews took place in 2018–2019 and analyzed with Graneheim and Lundman's content analysis strategy. Results The interviewees’ views reflected the changes they experienced in the wake of healthcare reforms in specialist healthcare services and municipal healthcare institutions. Three themes emerged from the analyses: (1) increased efficiency requirements after the Coordination Reform, (2) better reporting systems and the need for role clarifications in contact with hospitals, and (3) the need for good assessments for safe transfer to the municipality. Discussion Purchaser unit employees’ experiences with patient pathways point towards a need for certain changes. There is a need for increased efficiency requirements for purchasing units, even with new electronic tools, as well as a growing need for better reporting systems and a common understanding between the service levels about what patients can expect in the municipalities.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45660384","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}
Y. Couturier, S. Lanoue, Marlène Karam, Maxime Guillette, C. Hudon
{"title":"Social workers coordination in primary healthcare for patients with complex needs: A scoping review","authors":"Y. Couturier, S. Lanoue, Marlène Karam, Maxime Guillette, C. Hudon","doi":"10.1177/20534345221122952","DOIUrl":"https://doi.org/10.1177/20534345221122952","url":null,"abstract":"Introduction Care coordination has been part of social work for some time. It has been recognized as contributing to care coordination for long-term care for the elderly and mental health but less is known about their contribution in primary care with patients with complex health and social needs. As social workers are increasingly present in primary healthcare, this scoping review aims to provide a synthesis of social workers’ coordination activities for patients with complex needs in primary healthcare. Methods CINAHL, Medline, Scopus, SocioIndex, Social Work Abstracts, and ProQuest databases were searched, from 2004 to 2020 for peer-reviewed literature. A thematic analysis using deductive and inductive approaches was used to conduct this scoping review. Results Eighteen studies on 11 different care coordination interventions were included. The care coordination activities have been classified into four categories: 1) activities that target the patient, family, and caregivers; 2) activities that target health and social care professionals and services; 3) activities that link the patient and family with health and social professionals and services; and 4) cross-cutting activities that support and enhance other activity. Discussion A variety of care coordination interventions conducted by social workers were identified, all of which included related but different activities. Still, the common aim is to reduce fragmentation of care. Social workers, because of their disciplinary skills characterized by linkages to nonmedical services, can make a significant contribution to the coordination of care in primary health care, in collaboration with nurses.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43203109","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}