Journal of Integrated Care最新文献

{"title":"Recruitment to social care roles in remote and rural contexts; strengthening the weakest link in integrated care?","authors":"Stephen Gibb","doi":"10.1108/jica-05-2023-0030","DOIUrl":"https://doi.org/10.1108/jica-05-2023-0030","url":null,"abstract":"PurposeRecruitment to social care roles can be the weakest link in many integrated systems, with vacancy rates being very high compared to other sectors, especially in remote and rural places. Analysis of Employer Value Propositions (EVPs) in social care can capture and challenge perceptions of care work.Design/methodology/approachThis study of EVP in four organisations in a rural setting in Scotland focussed on young people as a target demographic. This study interprets recruitment challenges in social care in three contexts, the technical-instrumental, the hermeneutic and the emancipatory.FindingsEVP articulation is at present not effective. Refreshed and new messaging has potential to attract, employ and nurture young people to the social care sector in remote and rural places.Research limitations/implicationsRecruiting to social care vacancies is crucial for sustainable social care. Improving the recruitment of young people is a key part of the longer-term solution. More studies on recruitment in a variety of remote and rural contexts, with a range of demographics, are needed.Practical implicationsThe potential impact is attracting more young people to the social care workforce, enhancing capacity for integrated care improving lives for people who receive care and for paid care workers and unpaid carers.Social implicationsRemote and rural areas often feature a generational imbalance, with more older people from in-migration and fewer young people from out-migration. Employment in social care has the capacity to redress that to some extent.Originality/valueThis study is original in outlining the messages and methods that can be adopted to boost recruitment to social care.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"24 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87835371","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":"Exploring the spread and scale of a web-based clinical decision support portal in Sydney, Australia, during COVID-19: a case study","authors":"A. McGlynn, Éidín Ní Shé, P. Bennett, S. Liaw, Tony Jackson, Ben Harris-Roxas","doi":"10.1108/jica-01-2023-0006","DOIUrl":"https://doi.org/10.1108/jica-01-2023-0006","url":null,"abstract":"PurposeHealthPathways is an online decision support portal, primarily aimed at General Practitioners (GPs), that provides easy to access and up to date clinical, referral and resource pathways. It is free to access, with the intent of providing the right care, at the right place, at the right time. This case study focuses on the experience and learnings of a HealthPathways program in metropolitan Sydney during the COVID-19 pandemic. It reviews the team's program management responses and looks at key factors that have facilitated the spread and scale of HealthPathways.Design/methodology/approachAvailable data and experiences of two HealthPathways program managers were used to recount events and aspects influencing spread and scale.FindingsThe key factors for successful spread and scale are a coordinated response, the maturity of the HealthPathways program, having a single source of truth, high level governance, leadership, collaboration, flexible funding and ability to make local changes where required.Originality/valueThere are limited published articles on HealthPathways. The focus of spread and scale of HealthPathways during COVID-19 is unique.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"26 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90909957","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":"Media presentation of hospital discharge to care homes during the COVID-19 pandemic","authors":"E. Abe, P. Dawson, J. Scott","doi":"10.1108/jica-02-2023-0013","DOIUrl":"https://doi.org/10.1108/jica-02-2023-0013","url":null,"abstract":"PurposeAt the outset of the COVID-19 pandemic the United Kingdom Government implemented a policy to rapid discharge hospital patients into care homes. This study aimed to examine how the media in the United Kingdom portrayed hospital discharge to care homes during the COVID-19 pandemic.Design/methodology/approachThis study was a qualitative document analysis. Four sources (Daily Mail, The Independent, The Guardian and BBC News) were selected to represent political orientations encompassing right-wing, centrist and left-wing perspectives, and were searched for mention of hospital discharge, care homes and Covid-19 pandemic between 1st January 2020 and 24th February 2022. Article text was copied verbatim into Microsoft Word documents prior to analysis. Data were thematically analysed, followed by coding the sentiment in the included articles as well as coding the sentiment of themes and sub-themes.FindingsOf 722 identified articles, 133 were eligible for inclusion as the final corpus. Data represented a moralistic narrative consisting of four themes: (1) Government as villain, (2) care homes as antiheroes, (3) patients as ideal victims and (4) moral outcomes. Most of the corpus had a negative sentiment (78.1%). One theme, moral outcomes, had considerably more positive sentiment (32.4%) than others (range 15.1%–21.9%).Originality/valueA moralistic argument for improving cross-boundary interactions between health and social care services is provided, and the media can play a role pushing cross-boundary working higher up the policy agenda. Future work should examine how direct stakeholders, including those working in healthcare and care home settings, perceived the discharge policy.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"463 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77727580","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":"An integrated multisectoral and multidisciplinary community of practice collaboration to enhance child wellbeing in South Africa","authors":"S. Haffejee, Sonia Mbowa, L. Patel","doi":"10.1108/jica-04-2023-0021","DOIUrl":"https://doi.org/10.1108/jica-04-2023-0021","url":null,"abstract":"PurposeThere is a growing call both globally and nationally for integrated multisectoral and multidisciplinary systems of care to be implemented for children's needs in the foundation stages of their growth to be met. Extant literature shows that historical, structural, epidemiological, political and social factors create many adversities for South African children both in the short and in the long term. South Africa's fragmented and weak service delivery compounds the situation. In this paper, the authors describe the lessons learnt from a multisectoral and multidisciplinary community of practice established to strengthen social systems to ensure child wellbeing outcomes.Design/methodology/approachA qualitative research design was used, drawing on data collected over a two-year period. Data included meeting minutes, focus group discussions, and email communications between project partners. Focus group discussions were audio-recorded and transcribed verbatim. Data was analysed thematically.FindingsFindings show that having a shared goal, establishing supportive, mutually beneficial relationships and contributing to services that enhance child wellbeing outcomes enabled the community of practice, while differing organizational mandates and heavy workloads constrained the partnership.Research limitations/implicationsThe study shows the effectiveness of a Community of Practice (CoP) in integrating services across sectors for children's well-being and promoting collaborative learning and intersectoral work. However, this success also depends on the presence of strong leadership and efficient coordination.Limitation: Despite its benefits, the CoP model presents challenges, including securing active participation and buy-in from stakeholders, managing time and resource constraints, and dealing with issues in the existing service delivery system. Questions about long-term sustainability and the practicalities of scaling and institutionalizing the model need to be addressed.Originality/valueThrough this paper, the authors contribute to a nascent area of research in the Global South, critically reflecting on the lessons the authors learnt from implementing an integrated community of practice approach to strengthen social sector systems toward the enhancement of children's wellbeing.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"34 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85413614","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":"Editorial: Integrated care – power to the patients?","authors":"A. Kaehne","doi":"10.1108/jica-07-2023-092","DOIUrl":"https://doi.org/10.1108/jica-07-2023-092","url":null,"abstract":"The participants of the most recent International Conference on Integrated Care will have now made their way home, undoubtedly still buoyed and exhilarated by many fascinating conversations. They will have had countless impressions of innovative and, sometimes, ground breaking approaches in integrated care research and practice. Looking back over these days in the Belgium city of Antwerp, I am struck in particular by the way in which patients themselves have moved centre stage in many integrated care programmes and discussions. Increasingly, the role of patients in designing and producing care is emphasised and receives attention, be it through a renewed focus on their health literacy, their competencies to navigate still fragmented health systems or their ability to deal with organisational or professional boundaries. I have long argued for a more prominent place of patients in our conversations about integrated care solutions. The predominance of professional and organisational perspectives in integrated care research and practice was always unhealthy, even though perhaps initially necessary in order to understand the barriers to improving health care services. Yet mapping patient experiences, whilst common practice in business studies, happened far too rarely in our research community, where sophisticated and overwrought modelling often buried common sense approaches to difficult, yet simple problems of fragmentation and lack of collaboration. Learning from those who use services comes natural to those working in business, since business leaders, by definition, need to understand the needs of those they serve. It throws a revealing light on health service research and integrated care that patients rarely receive the same red carpet treatment in our field. We profess to do integrated care for patients but when it comes to asking them the simple question of what would improve their journey through our health systems we treat their answers as launching pads for convoluted research studies into organisational complexity and multiprofessional compartmentalisation. I am not advocating theoretical Luddism or ignorance of the, at times, beautiful modelling that produces novel insights and knowledge into why something works (or does not). But I do think that often the answers to issues of fragmented care are simpler than we think. It may be the consultant picking up the phone to their colleague to discuss a case rather than filing a message on the system that may or may not be seen. Or it may be the nurse double checking that the next shift has actually been updated on the patient that is to be transferred to the other unit. So what about the patient in all this? Some of us are hoping that a growth in patient power, in combination with increasing competencies and health literacy will bring about improved patient experiences. As with everything else, however, there are likely to be winners and losers with this scenario. Activist patients are most likely","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"234 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74509415","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":"Antecedents of physicians' intentions to engage in digital volunteering work: an extended technology acceptance model (TAM) approach","authors":"Ahmed Chemseddine Bouarar, Smail Mouloudj, Tungki Pratama Umar, Kamel Mouloudj","doi":"10.1108/jica-03-2023-0017","DOIUrl":"https://doi.org/10.1108/jica-03-2023-0017","url":null,"abstract":"PurposeThe digitalization has changed the volunteer paradigm, making young volunteers use technology in their volunteering activities. The current study sets out to identify and model the antecedents that determine intention to engage in digital health volunteering among Algerian physicians to give insights promoting the development of digital volunteering in different countries of the world.Design/methodology/approachTo this end, the authors used a survey design to extend the technology acceptance model (TAM) with two construct (self-efficacy and perceived risk of COVID-19 infection). A convenience sample of 163 physicians; working in the private and public sectors in six provinces of Algeria was selected. The data were analyzed through a multiple linear regression.FindingsThe findings show that the perceived usefulness, ease of use, attitudes toward digital volunteering, level of self-efficacy and perceived risk of COVID-19 infection have a significant positive effect on physicians' intentions to engage in digital volunteering work in the context of health crises.Practical implicationsThis study reveals that engaging in digital volunteering can be promoted during health crises as an effective strategy to provide support and assist public health institutions and emergency management.Originality/valueTo the best of the authors' knowledge, this is the first study from Africa that explores digital volunteer work, and the first study that extends the TAM to investigate digital volunteer intention among physicians.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"108 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82397801","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":"The organisation of paediatric hospital-at-home care: a multi-country comparative study","authors":"M. Lefèvre, J. Detollenaere, R. Zeevaert, C. Van de Voorde","doi":"10.1108/jica-05-2023-0031","DOIUrl":"https://doi.org/10.1108/jica-05-2023-0031","url":null,"abstract":"PurposeMany countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults, paediatric HAH has been developed more recently. Specificities of paediatric care make it difficult to directly extend an adult HAH model to the paediatric population. The objective of this study is to compare the organisation of paediatric HAH in four countries: France, Australia (states of Victoria and New South Wales), the Netherlands and Belgium. Ultimately, lessons can be drawn for further development in the countries analysed and/or for implementation in other countries.Design/methodology/approachLegal documents and other grey literature were analysed to describe the legal context for the provision of paediatric HAH in the selected countries. In addition, semi-structured in-depth interviews were conducted with key informants from paediatric HAH organisations in these countries, addressing the following topics: historical background, legal framework, functioning of HAH models, workforce, number of services, profile of children, type of care activities, funding, coordination with other providers and quality of care. Results were reviewed by a content expert from the respective country.FindingsOrganisational differences were highlighted in terms of coordinating actor (hospital or home nursing care services), decision-making process, range of clinical conditions treated, territorial organisation, qualifications and expertise of the team members, medical expertise, financing, responsibilities, etc.Originality/valueThere is no single preferred model for the provision of HAH care for children. There is a large variety in almost all aspects of organisation. There are, however, also some common characteristics across the different models. Notably, paediatric expertise of nurses within the HAH team was considered indispensable in all programmes.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77996853","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":"Meeting the complex health and social care needs of older adults: a response to the recent viewpoint paper on “how to handle gerontocracy”","authors":"J. Feather","doi":"10.1108/jica-06-2023-0039","DOIUrl":"https://doi.org/10.1108/jica-06-2023-0039","url":null,"abstract":"PurposeThis paper aims to provide a response to the previously published paper on “Gerontocracy”.Design/methodology/approachThis paper views care services through the lens of safeguarding, risks and responsibility in contradistinction from the largely economic and cost relevant argument put forward in the original paper.FindingsThis paper articulates the contribution of informal carers to integrated care solutions solely from an economic perspective overlooks the wider human and social dimensions of care provision in society.Originality/valueEngaging in the wider debate about the status, contribution of informal carers to care solutions highlights the complexity of the carers' role in society which should evoke a more holistic debate of this important topic.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"55 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74432650","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":"COVID-19: a catalyst for change in remote and rural advanced clinical practice – A qualitative study","authors":"R. King, C. Carolan, S. Robertson","doi":"10.1108/jica-03-2023-0014","DOIUrl":"https://doi.org/10.1108/jica-03-2023-0014","url":null,"abstract":"Purpose The purpose of this study is to explore the sustainability of innovations introduced during the coronavirus disease 2019 (Covid-19) pandemic in remote and rural primary care advanced clinical practice.Design/methodology/approach The methodology includes an exploratory qualitative study of eight key stakeholders from Scottish remote and rural primary care advanced practice (three policymakers and five advanced practitioners). Data were collected using semi-structured interviews during 2022 and analysed thematically.Findings Advanced practice in remote and rural primary care is characterised by a shortage of doctors, close-knit communities and a broad scope of practice. Covid-19 catalysed changes in the delivery of healthcare. Innovations which participants wanted to sustain include hybrid working, triage, online training and development, and increased inter-professional support networks.Practical implications Findings provide valuable insights into how best to support remote and rural advanced practice which may have implications for retaining healthcare professionals. They also identified useful innovations which could benefit from further investment.Originality/value Given current healthcare workforce pressures, identifying and sustaining innovations which will support and retain staff are imperative. Hybrid consultations and online access to training, development and support should be sustained to support the remote and rural advanced practice workforce. Further research should explore the sustainability of innovations introduced during the Covid-19 pandemic in other care contexts.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91394001","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":"Exploring clinicians’ experiences of how efficient virtual elective knee clinics are compared to traditional face-to-face clinics","authors":"Ronan Henry","doi":"10.1108/jica-10-2022-0051","DOIUrl":"https://doi.org/10.1108/jica-10-2022-0051","url":null,"abstract":"Purpose Efficient delivery of integrated healthcare requires solid alliances and collaboration with stakeholders on a regular basis. Due to coronavirus disease 2019 (COVID-19), it has become necessary to explore new ways of delivering integrated healthcare, and virtual clinics have offered one solution and are likely to continue due to the uncertainty with COVID-19. This study aims to explore clinicians’ experiences of how efficient virtual elective knee clinics (VEKC) are in an orthopaedic setting in comparison to traditional face-to-face clinics.Design/methodology/approach The study utilised a mixed-methods study to obtain qualitative and quantitative data. This involved an anonymous online survey in addition to in-depth qualitative interviews conducted with a purposive sample of multidisciplinary colleagues who work with the VEKC in an acute hospital.Findings Three overarching themes and nine sub-themes emerged in the qualitative analysis. Overall, clinicians in both the quantitative and qualitative aspects of the study highlighted several ways that virtual clinics are efficient from both the patient and health service perspective. However, participants also highlighted barriers in relation to virtual clinics not being suitable for certain cohorts of patients and pathologies.Originality/value This is the first study in Ireland to provide valuable insights into the experiences of multidisciplinary clinicians using VEKC and their efficiency compared to traditional face-to-face clinics.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79776925","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}