Journal of Integrated Care最新文献

{"title":"Person-centred integrated care with a health promotion/public health approach: a rapid review","authors":"T. Burdett, J. Inman","doi":"10.1108/jica-02-2021-0010","DOIUrl":"https://doi.org/10.1108/jica-02-2021-0010","url":null,"abstract":"PurposeDue to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena.Design/methodology/approachA systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Papers included in this review focused upon person-centred integrated care and a health promotion/public health approach (January 2018–October 2020). Papers were excluded due to not being written in English, not fitting the age criteria and not being peer reviewed.FindingsEight studies met the inclusion criteria and three overarching themes were identified with regards to person-centred integrated care as a health promotion/public health approach: Core components; Development, implementation, and evaluation of models of care and relationship to population health and wellbeing outcomes.Research limitations/implicationsThe need for person-centred integrated care as a health promotion/public health approach, to enhance population health and well-being outcomes requires further research to continue to develop, implement and evaluate models of care.Originality/valueThe international scope of this contemporary review brought together the three concepts of person-centred integrated care and public health, exploring the translation of policy into practice (WHO, 2016). The juxtaposition of public health approaches in the background/consequential or foreground/active agent demonstrates how promotion, prevention and population health can be re-valued in integrated people-centred health services (WHO, 2016).","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"382 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74681666","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":"Achieving person-centredness through technologies supporting integrated care for older people living at home: an integrative review","authors":"J. MacInnes, J. Billings, A. Dima, Christopher Farmer, G. Nijpels","doi":"10.1108/JICA-03-2021-0013","DOIUrl":"https://doi.org/10.1108/JICA-03-2021-0013","url":null,"abstract":"PurposeThe purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.Design/methodology/approachAn integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.FindingsTwelve studies were included in the review. Three studies described remote consultations, particularly telemedicine;five studies described tools to support self-management;three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies;co-ordination and integration of services;the implementation of digital technologies;and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.Originality/valueThis review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"2 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87327289","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":"Leadership challenge: lateral systems integration for healthcare","authors":"L. Martin","doi":"10.1108/JICA-12-2020-0074","DOIUrl":"https://doi.org/10.1108/JICA-12-2020-0074","url":null,"abstract":"PurposeGovernment imperatives that drive integrated care are challenging corporate executive leadership. Conspicuous by its absence in both government's imperatives and the literature, is any reference to corporate executive leadership in transitioning a hierarchically oriented health system to a laterally integrated health system referred to, in this paper, as an integrated health system. This lack of reference to executive leadership involvement conveys either significant consequences or opportunities for corporate healthcare executives. The purpose of this qualitative, multi-case study is to explore corporate executive leadership in transitioning a hierarchically oriented health system to an integrated health system.Design/methodology/approachBetween December 2017 and February 2018, a qualitative methodology and multi-case study design facilitated one hour telephone interviews with 11 presidents and four senior vice presidents. Critical case sampling was used to select the study sample from a target population of 246 corporate healthcare executives representing Ontario's major acute healthcare organizations/systems.FindingsCorporate healthcare executives possess the requisite skills and knowledge to transition a hierarchically oriented to a laterally integrated the health system but are constrained by an undefined partnership role with government and fear of government changes.Originality/valueThis paper provides corporate executive leaders with a systematic leadership approach to organizational readiness, in transitioning to an integrated health system. Features and outcomes of the approach are illustrated.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"12 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84882777","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":"Health care providers' experiences with delivering person centred care in an Integrated Care Program for thoracic surgery patients in Ontario, Canada","authors":"K. Kornas, Meghan O’Neill, Catherine Y Liang, L. Diemert, Tsoleen Ayanian, Melissa Chang, L. Rosella","doi":"10.1108/JICA-10-2020-0068","DOIUrl":"https://doi.org/10.1108/JICA-10-2020-0068","url":null,"abstract":"PurposeThe purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.Design/methodology/approachThe authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.FindingsThe IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.Originality/valueThis study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"88 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81311861","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":"Person-centred communication in long-term care with older people: a scoping review","authors":"D. Lombard","doi":"10.1108/JICA-10-2020-0070","DOIUrl":"https://doi.org/10.1108/JICA-10-2020-0070","url":null,"abstract":"PurposeInterpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations for a person-centred, joined-up approach. However, the term is used as a composite and its definition lacks shape and focus. In existing literature, participants appear to be selected on the basis of specific illnesses rather than age. Better understanding of the features of everyday communication processes associated with person-centred care can lead to improvements in policy and practice.Design/methodology/approachA scoping review examined communication features associated with person-centred care for older adults. This identified the extent and nature of literature. Several databases were searched; after screening and hand-searching, 31 were included. Findings were analysed for patterns and contradictions, against the objectives of person-centred and integrated care.FindingsEmotional intelligence and the ability to employ various communication styles are crucial skills of person-centred communication. Such approaches can have positive effects on the well-being of older people.Research limitations/implicationsSome studies' validity was weakened by methodological designs being founded on value judgements.Practical implicationsUsing personalised greetings alongside verbal and non-verbal prompts to keep residents emotionally connected during personal care is considered good practice. Stimulating feedback from people using services and their relatives is important.Originality/valueThe role of communication is highlighted in many professional guidance documents on person-centred and integrated care, but the process of implementation is decentralised to individual employers and workers. This paper draws on the findings of contemporary literature, grounded in naturalistic data, with implications for practice and policy.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"2 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86267514","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":"Multiagency working between children's social care and schools during COVID-19: case study experiences from English local authorities and international reflections","authors":"M. Baginsky, J. Manthorpe","doi":"10.1108/JICA-01-2021-0004","DOIUrl":"https://doi.org/10.1108/JICA-01-2021-0004","url":null,"abstract":"PurposeA multiagency approach to supporting and enhancing child welfare lies at the heart of policies and practice in England and many other countries. The assumption is that if professionals together from different disciplines share their knowledge and skills this will lead to better outcomes for children and their families. The COVID-19 pandemic interrupted the “normal practice” of such arrangements. This research explored how the pandemic's disruption led to new ways of communicating and professional behaviour, while exploring the potential for longer-term impact in England and other jurisdictions.Design/methodology/approachCase studies were conducted in 2020 in five English local authorities to explore how schools worked with Children's Social Care and other professionals during the COVID-19 period. It was supplemented by a survey of schools and discussions with and reflections from those with relevant experience in five other countries.FindingsMany schools played an extended role in supporting vulnerable and “in need” families during this period. Children's Social Care recognised their contributions and the improved communication achieved, although schools were divided over whether relationships had improved. Most communication and meetings were online; while benefits were noted there were concerns for families who were digitally disadvantaged.Originality/valueThe work provides a contemporary picture of multiagency work during the 2020 pandemic and identifies factors which may shape this work in the future in England and internationally.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"337 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76567540","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":"A journey towards integrated person-centred care: a case study of a mental health perspective in the voluntary sector","authors":"Louise Kermode","doi":"10.1108/JICA-10-2020-0064","DOIUrl":"https://doi.org/10.1108/JICA-10-2020-0064","url":null,"abstract":"PurposePerson-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry.Design/methodology/approachThis case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care.FindingsA focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration.Originality/valueThis case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"21 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84128535","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":"Making a difference: workforce skills and capacity for integrated care","authors":"Joy Akehurst, Paul Stronge, Karen Giles, J. Ling","doi":"10.1108/JICA-05-2020-0030","DOIUrl":"https://doi.org/10.1108/JICA-05-2020-0030","url":null,"abstract":"Purpose –The aimof this action researchwas to explore, from aworkforce and a patient/carer perspective, the skills and the capacity required to deliver integrated care and to inform future workforce development and planning in a new integrated care system in England. Design/methodology/approach – Semi-structured interviews and focus groups with primary, community, acute care, social care and voluntary care, frontline andmanagerial staff andwith patients and carers receiving these services were undertaken. Data were explored using framework analysis. Findings – Analysis revealed three overarching themes: achieving teamwork and integration, managing demands on capacity and capability and delivering holistic and user-centred care. An organisational development (OD) process was developed as part of the action research process to facilitate the large-scale workforce changes taking place. Research limitations/implications – This study did not consider workforce development and planning challenges for nursing and care staff in residential, nursing care homes or domiciliary services. This part of the workforce is integral to the care pathways for many patients, and in line with the current emerging national focus on this sector, these groups require further examination. Further, data explore service users’ and carers’ perspectives onworkforce skills. It proved challenging to recruit patient and carer respondents for the research due to the nature of their illnesses. Practical implications –Many of the required skills already existed within the workforce. The OD process facilitated collaborative learning to enhance skills; however, workforce planning across a whole system has challenges in relation to data gathering and management. Ensuring a focus on workforce development and planning is an important part of integrated care development. Social implications –This study has implications for social and voluntary sector organisations in respect of inter-agency working practices, as well as the identification of workforce development needs and potential for informing subsequent cross-sector workforce planning arrangements and communication. Originality/value – This paper helps to identify the issues and benefits of implementing person-centred, integrated teamworking and the implications for workforce planning and OD approaches.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"59 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84098414","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":"Bumpy road: implementing integrated psychiatric and somatic care in joint-specialty emergency departments: a mixed-method study using Normalization Process Theory","authors":"Pia Vedel Ankersen, Rikke Grynderup Steffensen, Emely Ek Blæhr, Kirsten Beedholm","doi":"10.1108/JICA-07-2020-0047","DOIUrl":"https://doi.org/10.1108/JICA-07-2020-0047","url":null,"abstract":"PurposeLife expectancy is 15–20 years shorter for individuals with than for people without mental illness. Assuming that undiagnosed and undertreated somatic conditions are significant causes, the Central Denmark Region set out to implement joint psychiatric and somatic emergency departments (EDs) to support integrated psychiatric/somatic care as an effort to prolong the lifetime of individuals with mental illness. Through the lens of Normalization Process Theory, the authors examine healthcare frontline staff’s perceptions of and work with the implementation of integrated psychiatric/somatic care in the first joint-specialty ED in Denmark.Design/methodology/approachA single-case mixed-methods study using Normalization Process Theory (NPT) as an analytic framework to evaluate implementation of psychiatric/somatic integrated care (IC) in a joint-specialty emergency department. Data were generated from observations, qualitative interviews and questionnaires distributed to the frontline staff.FindingsImplementation was characterized by a diffuse normalization leading to an adaption of the IC in a fuzzy alignment with existing practice. Especially, confusion among the staff regarding how somatic examination in the ED would ensure prolonged lifetime for people with mental illness was a barrier to sense-making and development of coherence among the staff. The staff questioned the accuracy of IC in the ED even though they recognized the need for better somatic care for individuals with mental illness.Practical implicationsThis study highlights that a focus on outcomes (prolonging lifetime for people with mental illness and reducing stigmatization) can be counterproductive. Replacing the outcome focus with an output focus, in terms of how to develop and implement psychiatric/somatic IC with the patient perspective at the center, would probably be more productive.Originality/valueIn 2020, the Danish Health Authorities published new whole-system recommendations for emergency medicine (EM) highlighting the need for intensifying integrated intra and interorganizational care including psychiatric/somatic IC (ref). Even though this study is not conclusive, it points to subjects that can help to identify resources needed to implement psychiatric/somatic IC and to pitfalls. The authors argue that the outcome focus, prolonging the lifetime for individuals with mental illness by identifying somatic illness, was counterproductive. In accordance with the recommendations of contemporary implementation studies, the authors recommend a shift in focus from outcome to output focus; how to develop and implement psychiatric/somatic IC.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"48 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88780587","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":"Coordination of paediatric oncology care: an explorative Swedish case study","authors":"C. Gadolin, E. Eriksson, Patrik Alexandersson","doi":"10.1108/JICA-10-2020-0063","DOIUrl":"https://doi.org/10.1108/JICA-10-2020-0063","url":null,"abstract":"The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.,A qualitative case study primarily consisting of interviews.,The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.,The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"26 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79738469","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}