International Journal of Care Coordination最新文献_第5页

Broadening the scope of task shifting in the organisation of healthcare 扩大医疗保健组织中任务转移的范围

IF 1.4

International Journal of Care Coordination Pub Date : 2021-08-18 DOI: 10.1177/20534345211039988

L. van Tuyl, B. Vrijhoef, M. Laurant, A. D. de Bont, R. Batenburg

{"title":"Broadening the scope of task shifting in the organisation of healthcare","authors":"L. van Tuyl, B. Vrijhoef, M. Laurant, A. D. de Bont, R. Batenburg","doi":"10.1177/20534345211039988","DOIUrl":"https://doi.org/10.1177/20534345211039988","url":null,"abstract":"Task shifting in healthcare has mainly been initiated and studied as a way to react to/or mitigate workforce shortages. Here, we define task shifting as the structural redistribution of tasks, usually including responsibilities and competencies between different professions. As such, task shifting is commonly focused on highly specialised and trained professionals who hand-over specific, standardised tasks to professionals with lower levels of education. It is expected that this type of task shifting will lead to efficiency and cost savings to healthcare organisations. Yet, there are more benefits to task shifting, in particular its contribution to integrated patient-centred quality of care and a tailored system that meets the changing care demands in society. Hence the importance to broaden the scope of task shifting, its goals, manifestations and how task shifting plays a role in addressing both the strengths and weaknesses in the healthcare system. In this focus piece, trends and conditions for task shifting and its (un)anticipated effects are discussed. We argue that, only when designed to face specific complexities at the workplace and taking into account the balance between specialists and generalists, task shifting may substantially contribute to enhanced quality of care that meets the changing needs of society.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"91 - 95"},"PeriodicalIF":1.4,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43477866","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}

引用次数: 4

Putting patients at the centre of health care 把病人放在医疗保健的中心

IF 1.4

International Journal of Care Coordination Pub Date : 2021-06-01 DOI: 10.1177/20534345211019964

H. Vrijhoef

引用次数: 6

Communication surrounding initiation and withdrawal of non-invasive ventilation in adults with Motor Neuron(e) Disease: clinicians’ and family members’ perspectives 运动神经元(e)疾病成人无创通气启动和退出的沟通:临床医生和家庭成员的观点

IF 1.4

International Journal of Care Coordination Pub Date : 2021-05-09 DOI: 10.1177/20534345211010132

C. Chapman, Sara Bayes, Moira Sim

{"title":"Communication surrounding initiation and withdrawal of non-invasive ventilation in adults with Motor Neuron(e) Disease: clinicians’ and family members’ perspectives","authors":"C. Chapman, Sara Bayes, Moira Sim","doi":"10.1177/20534345211010132","DOIUrl":"https://doi.org/10.1177/20534345211010132","url":null,"abstract":"Introduction International guidelines recommend that health care clinicians communicate with people with MND and their family members about non-invasive ventilation (NIV) and percutaneous gastrostomy tube (PEG) prior to or at the onset of respiratory symptoms. This study sought to discover the degree to which these recommendations are followed in practice. Methods Interpretive Description methodology was employed. Nineteen clinicians experienced in caring for people with MND, six relatives of recently deceased people with MND and one person with MND participated in semi-structured in-depth interviews. Clinicians’ accounts of NIV and PEG related communications were compared to family member participants’ recollections of their own discussions with clinicians. Data were analysed thematically. Results Six major themes emerged that together capture the factors that impact practitioner-patient-family communications about NIV and PEG. Some clinicians were unaware of MND guidelines particularly communicating the burdens or possible withdrawal of NIV or found them challenging to implement. Consequently, family participants reported that they and their relatives with MND found clinicians’ communication on these topics inadequate. This led to them ‘topping up’ their knowledge from less authoritative sources, predominantly the internet. Discussion Clinicians’ lack of awareness of the international guidelines and discomfort about discussing the benefits and burdens of NIV and PEGs means some people with MND and their families may be unprepared for the consequences of using and ceasing NIV.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"96 - 106"},"PeriodicalIF":1.4,"publicationDate":"2021-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20534345211010132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42014683","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}

引用次数: 3

Patient handover in a European border region: Cross-sectional survey study among healthcare workers to explore the status quo, potential risks, and solutions 欧洲边境地区的患者交接：医护人员的横断面调查研究，以探索现状、潜在风险和解决方案

IF 1.4

International Journal of Care Coordination Pub Date : 2021-04-21 DOI: 10.1177/20534345211009434

Mara E J Bouwmans, Juliëtte A Beuken, D. Verstegen, Laura van Kersbergen, D. Dolmans, Lina Vogt, S. Sopka

{"title":"Patient handover in a European border region: Cross-sectional survey study among healthcare workers to explore the status quo, potential risks, and solutions","authors":"Mara E J Bouwmans, Juliëtte A Beuken, D. Verstegen, Laura van Kersbergen, D. Dolmans, Lina Vogt, S. Sopka","doi":"10.1177/20534345211009434","DOIUrl":"https://doi.org/10.1177/20534345211009434","url":null,"abstract":"Introduction While the popularity of international care is rising, the complexity of international care compromises patient safety. To identify risks and propose solutions to improve international care, this study explores experiences of healthcare workers with international handovers in a European border region. Methods A cross-sectional survey design was used to reach out to 3000 healthcare workers, working for hospitals or emergency services in three neighboring countries in the Meuse-Rhine Euregion. In total, 846 healthcare workers completed the survey with 35 closed- and open-ended questions about experiences with international patient handover. Results One-third of respondents had been involved in international handover in the previous month. The handovers occurred in planned and acute care settings and were supported by numerous, yet varying standardized procedures. Healthcare workers were trained for this in some, but not all settings. Respondents mentioned 408 risks and proposed 373 solutions, which were inductively analyzed. Six identified themes classify the level on which risks and accompanying solutions can be found: awareness, professional competencies, communication between professionals, loss of information, facilities and support, and organizational structure. Discussion This study gives insight in international patient handovers in a European border region. Among the biggest risks experienced are procedural differences, sharing patient information, unfamiliarity with foreign healthcare systems, and not knowing roles and responsibilities of peers working across the border. Standardization of procedures, harmonization of systems, and the possibility for healthcare workers to get to know each other will contribute to reach common ground and move towards optimized and patient-safer cross-border care.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"72 - 81"},"PeriodicalIF":1.4,"publicationDate":"2021-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20534345211009434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43805550","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}

引用次数: 2

Decision-making in complex health care situations: Shared understanding, experimenting, reflecting and learning 复杂医疗情况下的决策：共同理解、实验、反思和学习

IF 1.4

International Journal of Care Coordination Pub Date : 2021-04-19 DOI: 10.1177/20534345211008741

Antoinette T Reerink, J. Bussemaker, C. Leerink, J. Kremer

引用次数: 3

Patient experiences of integrated care within the United Kingdom: A systematic review 英国综合护理的患者体验:一项系统回顾

IF 1.4

International Journal of Care Coordination Pub Date : 2021-03-27 DOI: 10.1177/20534345211004503

L. Davidson, J. Scott, Natalie Forster

{"title":"Patient experiences of integrated care within the United Kingdom: A systematic review","authors":"L. Davidson, J. Scott, Natalie Forster","doi":"10.1177/20534345211004503","DOIUrl":"https://doi.org/10.1177/20534345211004503","url":null,"abstract":"Introduction Integrated care and patient experience are central to the coordination and delivery of high quality health and social care in the UK, but their joint application is poorly understood. This systematic review aimed to gain an understanding of patient experience within current integrated care services in the UK, and specifically, whether they reflect person-centred coordinated care (PCCC). Methods Following PRISMA, electronic databases (ProQuest, EBSCO and Cochrane Library) were searched from 2012 to 2019 for primary, peer-reviewed literature. Papers were included where patients’ or carers’ experiences of integrated care were reported. Papers were excluded where they focused on acute integrated care interventions, measured experience via satisfaction scores only, or findings lacked sufficient depth to answer the research question. Quality was assessed using Mixed Methods Appraisal Tool, and findings synthesised using a framework approach, incorporating the Rainbow Model of Integrated Care and Measuring Integrated Care Patient Framework. Results Sixteen studies were included. Person-centred and shared responsibility experiences were most often discussed. Experiences were not always described as positive and some patients experienced a lack of PCCC. Clinical, professional/organisational and functional integration processes were associated with experiencing domains of PCCC. Discussion People with complex needs experience a lack of coordination across teams and wider community resources, and limited associations were made between integration processes and patient experience. Further research which gives context to individual experience, provides greater detail of integration processes and utilises validated patient experience measures of PCCC is required to understand the association between integration processes and domains of PCCC.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"39 - 56"},"PeriodicalIF":1.4,"publicationDate":"2021-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20534345211004503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46797479","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}

引用次数: 10

Utilizing the care coordination Atlas as a framework: An integrative review of transitional care models 以护理协调图谱为框架:过渡性护理模式的综合综述

IF 1.4

International Journal of Care Coordination Pub Date : 2021-03-12 DOI: 10.1177/20534345211001615

Daphne E Chakurian, L. Popejoy

{"title":"Utilizing the care coordination Atlas as a framework: An integrative review of transitional care models","authors":"Daphne E Chakurian, L. Popejoy","doi":"10.1177/20534345211001615","DOIUrl":"https://doi.org/10.1177/20534345211001615","url":null,"abstract":"Introduction Care coordination reduces care fragmentation and costs while improving health care quality. Transitional care programs, guided by tested models are an important component of effective care coordination, and have been found to reduce adverse events and prevent hospital readmissions. Using the Care Coordination Atlas as a framework, this article reports an integrative review of two transitional care models including analysis of model components, implementation factors, and associated 30-day all-cause hospital readmission rates. Methods Integrative review methodology. PubMed and Scopus databases were searched from January 2015 to July 2020. Fourteen studies set in 18 skilled nursing facilities and 50 hospitals were selected for data extraction and analysis. Results The ReEngineered Discharge model had five components and the Better Outcomes by Optimizing Safe Transitions model had eight components in the nine Care Coordination Atlas domains. Communication dominated activities in both models while neither addressed accountability/responsibility. Implementation was influenced by leadership commitment to understanding complexity of the models, culture change, integration of models into workflows, and associated labor costs. Model implementation studies consistently reported improvements in facilities’ 30-day all-cause hospital readmission rates. Discussion The Care Coordination Atlas was a useful framework to guide analysis of transitional care models. Leadership commitment to and participation in model implementation is vital. The models do not focus beyond the immediate post-discharge period limiting the impact on chronic disease management. Frameworks such as the Care Coordination Atlas are useful to help guide development of care coordination activities and associations with readmission rates.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"57 - 71"},"PeriodicalIF":1.4,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20534345211001615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47918801","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}

引用次数: 3

Injection drug use, depression, and HIV screening in rural primary care settings: A retrospective cross-sectional study 农村初级保健环境中的注射吸毒、抑郁和HIV筛查：一项回顾性横断面研究

IF 1.4

International Journal of Care Coordination Pub Date : 2021-03-01 DOI: 10.1177/2053434521999903

S. Cody, D. Albright, J. McDaniel, S. McIntosh

{"title":"Injection drug use, depression, and HIV screening in rural primary care settings: A retrospective cross-sectional study","authors":"S. Cody, D. Albright, J. McDaniel, S. McIntosh","doi":"10.1177/2053434521999903","DOIUrl":"https://doi.org/10.1177/2053434521999903","url":null,"abstract":"Introduction Antiretroviral therapy (ART) has reduced HIV viral replication and transmission of disease. However, continuing incidence of new HIV infections has been attributed to undiagnosed HIV infections among injection drug users. This purpose of this retrospective cross-sectional study was to determine whether depression moderates the relationship between injection drug use and HIV screening among people with substance use in the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program. Methods Electronic health record data were obtained from three consenting medical facilities (n = 103). Multivariable logistic regression analysis was conducted to determine the moderating effect of depression on the relationship between injection drug use and HIV screening. Results Bivariate analyses revealed that HIV screening was more common among individuals not engaged in injection drug use, 75% and 57% respectively. Participants who had never been screened had worse depressive symptoms on the PHQ-2 (M = 3.00, SE = 0.42) than individuals who had been screened for HIV (M = 1.45, SE = 0.17). After controlling for demographic variables, tobacco use, alcohol consumption, and drug abuse, results indicated a moderating effect of depression on the relationship between injection drug use and receipt of HIV screening (aOR = 0.85 [95% CI = 0.84, 0.86). Discussion Findings suggest that high risk subgroups such as injection drug users with severe depression may not be using HIV prevention services, leading to possible delays in HIV diagnosis. Integration of behavioral interventions and HIV prevention services may reduce risk factors among depressed injection drug users. Such interventions may improve retention for injection drug users who experience worse depressive symptoms post HIV diagnosis.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"10 - 16"},"PeriodicalIF":1.4,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434521999903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47165759","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}

引用次数: 2

Effectiveness of a health and social care integration programme for home-dwelling frail older persons in Argentina 阿根廷为居住在家中的体弱老年人实施的保健和社会护理一体化方案的有效性

IF 1.4

International Journal of Care Coordination Pub Date : 2021-03-01 DOI: 10.1177/20534345211002114

G. Perman, Mariana Prevettoni, Tami Guenzelovich, M. Schapira, Verónica Martínez Infantino, Roxana Ramos, J. Saimovici, Cristian Gallo, M. Ferre, Silvana Scozzafava, Lucila Hornstein, L. Garfi

{"title":"Effectiveness of a health and social care integration programme for home-dwelling frail older persons in Argentina","authors":"G. Perman, Mariana Prevettoni, Tami Guenzelovich, M. Schapira, Verónica Martínez Infantino, Roxana Ramos, J. Saimovici, Cristian Gallo, M. Ferre, Silvana Scozzafava, Lucila Hornstein, L. Garfi","doi":"10.1177/20534345211002114","DOIUrl":"https://doi.org/10.1177/20534345211002114","url":null,"abstract":"Introduction The evidence of effectiveness of integrated care initiatives for home-dwelling frail older persons is still inconclusive. There is a need for more studies, especially in developing countries. Our objective was to assess the effectiveness of a health and social care integration programme versus the best standard of care to date in this population. Methods Quasi-experimental study performed in patients' homes in Buenos Aires, Argentina. The intervention arm had a health and social care counsellor that systematically reviewed the social and biological situation following a structured process, evaluating: functionality, nutrition, mobility, pain, cognition, medication reconciliation and adherence, need for care, quality of care, and environmental safety. The control group received the best standard of care to date, with access to the same health or social care services, but without the counsellor and related processes. The main outcome was the adjusted hazard ratio for hospitalizations after one year using a Cox-proportional hazards model. Results We recruited 121 persons in each group. The crude hazard ratio for hospital admissions, comparing the intervention to the control group was 0.622 (95% CI: 0.427–0.904; p = 0.013). The adjusted hazard ratio (aHR) was 0.503 (95% CI: 0.340–0.746; p = 0.001). The aHR for death was 0.993 (95% CI: 0.492–2.002; p = 0.984). The absolute difference in the quality of life was 16.59 points (95% CI: 12.03–21.14; p < 0.001). Discussion The integration programme had lower hospital admissions and better quality of life than the usual care. There was no significant difference in death rates.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"28 - 34"},"PeriodicalIF":1.4,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/20534345211002114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42415027","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}

引用次数: 3

Maintaining fair and efficient health care during the COVID-19 pandemic: Theoretical context and practical implications 在新冠肺炎大流行期间保持公平和高效的医疗保健：理论背景和实际意义

IF 1.4

International Journal of Care Coordination Pub Date : 2021-03-01 DOI: 10.1177/2053434521999959

C. Milionis, Maria Ntzigani, S. Milioni, I. Ilias

{"title":"Maintaining fair and efficient health care during the COVID-19 pandemic: Theoretical context and practical implications","authors":"C. Milionis, Maria Ntzigani, S. Milioni, I. Ilias","doi":"10.1177/2053434521999959","DOIUrl":"https://doi.org/10.1177/2053434521999959","url":null,"abstract":"Coronavirus disease 2019 is a respiratory infection that has evolved to a pandemic with an enormous burden both on human life and health care. States throughout the world have pursued strategies to restrict the transmission of the virus in the community. Health systems have a crucial dual role as they are at the frontline of the fight against the pathogen and at the same time they must continue to offer emergency and routine health services. The provision of health care in the context of the COVID-19 pandemic finds certain barriers. The simultaneous protection of both universal health coverage and health care efficiency is a difficult task due to conflicting challenges of these two goals. Key actions need to be decided and implemented in the fields of health policy, operation of health services, and clinical interaction between health personnel and patients, so that health care continues to perform its mission in a sustainable manner. As the scientific community prepares for the widespread production and application of effective protective and therapeutic agents against COVID-19, it is vital for the general population to remain safe and for the health systems to survive. Allocation of resources and priority setting need to be applied fairly and efficiently for the achievement of the maximum benefit.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"24 1","pages":"5 - 9"},"PeriodicalIF":1.4,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2053434521999959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46797913","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}

引用次数: 4