Journal of Integrated Care最新文献

{"title":"Impact of integrated behavioral health services on adherence to long-acting injectable antipsychotics","authors":"A. Maister, C. McCarthy, Lee G. Ruszczyk, Rachael Evans, Megan E. Maroney","doi":"10.1108/jica-08-2021-0046","DOIUrl":"https://doi.org/10.1108/jica-08-2021-0046","url":null,"abstract":"PurposeIntegrated health care occurs when specialty and general care providers work together to address both the physical and mental health needs of their patients. The Substance Abuse and Mental Health Services Administration model of integration is broken into six levels of coordinated, co-located and integrated care. Our institution offers both co-located and integrated care among eight clinic sites. The care team is typically composed of the primary care provider, nurse and medical assistant, but other professionals may be introduced based on the patient’s medical and psychiatric conditions. The purpose of this prospective, quality improvement study was to compare the rates of adherence to long-acting injectable antipsychotics (LAIAs) between both types of integrated primary care settings at our institution. The comparison of the two settings sought to determine which environment provides improved outcomes for patients with serious psychiatric illnesses. Additionally, we aimed to assess the quality of medication-related monitoring and care team composition between care settings, and the ability of pharmacists to deliver interprofessional care team training and education on LAI use in clinical practice.Design/methodology/approachSubjects were identified and included in the study if they had received primary care services from our institution within the previous 12 months. Patient demographic and laboratory variables were collected at baseline and when clinically indicated. The rates of adherence between care settings were assessed at intervals that align with the medication’s administration schedule (e.g. every four weeks). Medication-related monitoring parameters were collected at baseline and when clinically indicated. The interprofessional care team completed Likert scale surveys to evaluate the pharmacist’s LAIA education and training.FindingsThere was not a statistically significant difference detected between integrated primary care settings on the rates of adherence to LAIAs. Additionally, there was not a statistically significant difference between rates of adherence to medication-related monitoring parameters or the effect of the patient treatment team composition. There was a statistically significant difference between pre- and post-session survey scores following interprofessional education and training provided by a pharmacist.Originality/valueBecause overall rates of adherence were low, both primary care settings were found to be equivalent. Our study may have been underpowered to detect a difference in the primary endpoint because of the small sample size. However, our study demonstrates that interprofessional education and training may lend itself to changes in practice, which is evident by the clinically significant relative increase in adherence. The Henry J. Austin Health Center network will be implementing a standard operating procedure regarding LAIA management within the primary care setting. Further studies are needed to","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"24 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76990057","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":"Utilising dentist-dental health educator skill-mix to implement oral health promotion that better supports diverse communities","authors":"Bhaven Modha","doi":"10.1108/jica-08-2021-0043","DOIUrl":"https://doi.org/10.1108/jica-08-2021-0043","url":null,"abstract":"PurposeDentists may be seen as the most prominent figures within dentistry. Yet, a number of dental care professionals make significant contributions to the profession. The dental health educator (DHE) is one prime example. This teammate is typically a dental nurse who has achieved a post-registration qualification in oral health education (OHE). Through interactions with patients, members of the community and other pertinent stakeholders, the DHE empowers people through promoting the importance of good oral health. The purpose of this paper is to cast light on the unique and invaluable roles that DHEs can play within their organisations.Design/methodology/approachThis paper aims to share some examples of dentist-DHE collaborations, where OHE initiatives were implemented within an ethnically diverse London Borough in England.FindingsIt was found that such interprofessional, skill-mix efforts were more productive, when the dentist and DHE worked together, rather than the latter working independently.Originality/valueThere exists great potential for DHEs to act as ambassadors for their dental establishments, network and collaborate with other organisations and build worthwhile relations with other healthcare professionals and stakeholders.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"79 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77337273","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":"“One of the team” patient experience of integrated breast cancer care","authors":"H. Tucker","doi":"10.1108/jica-11-2021-0058","DOIUrl":"https://doi.org/10.1108/jica-11-2021-0058","url":null,"abstract":"PurposeThis paper presents my experience of breast cancer care in which I describe my care as positive and integrated.Design/methodology/approachI have applied an autoethnographical approach to my patient story to analyse my care in order to reflect and share insights. I have applied my knowledge and experience in integrated care through my research, management and practice.FindingsIn my patient story I describe being empowered and feeling like “one of the team.” Vertical and horizontal integration was evident across staff services and agencies. This included integrated working across multi‐disciplinary teams, between primary and secondary care and also between the NHS and a voluntary agency. I identified features that were important to me in my care under the headings of: certainty, communication, contact, compassion, continuity, cohesive, care and collaboration.Practical implicationsI consider the implications of sharing patient stories to inform quality improvement, influence education and training for staff and design support for patients. I consider how patients can be more involved in the evaluation of their care.Originality/valueThis viewpoint has been written from my perspective as a patient and a professional, and was written in order to recognise good practice and share the learning for continual quality improvement. There is every sign that person-centred integrated care is starting to be embedded in some of our services and hopefully this will be recognised, celebrated and sustained.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"38 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76883452","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":"Discourses of middle managers' cross-boundary collaboration in health and social care","authors":"Anneli Hujala, H. Taskinen, Sanna Laulainen, Charlotte Klinga, S. Schruijer","doi":"10.1108/jica-10-2021-0054","DOIUrl":"https://doi.org/10.1108/jica-10-2021-0054","url":null,"abstract":"PurposeIn the implementation of integrated care, the role of managers is important and their mutual collaboration should be addressed more visibly. The purpose of this study was to investigate how cross-boundary collaboration is constructed in the discourse of middle-level managers in health and social care.Design/methodology/approachThe study was based on a discursive approach. Group discussions with three groups of Finnish middle managers (n = 39) were analyzed using discourse analysis.FindingsFive ways of talking about cross-boundary collaboration were identified, labeled “ideal”, “structure”, “defence”, “money” and “support” discourses. In the ideal discourse, cross-boundary collaboration appeared as a “good thing” and is self-evident. Structural discourse defined managers as passive actors in self-sustaining entities. Defensive discourse highlighted the problems of cross-boundary collaboration and the hierarchy within the health and social sectors. Financial discourse constituted the ultimate obstacle to successful cross-boundary collaboration, and both strengthened and explained defensive discourse. Supportive discourse portrayed other managers as partners and as an important resource.Research limitations/implicationsCross-boundary collaboration can be experienced as a resource, helping managers cope with their workload. However, identification of and continuous attention to challenges at macro, meso and micro levels of integrated care is crucial for successful collaboration. Thus, critical discussion of collaboration needs to be given space.Originality/valueThe study design and discursive approach highlights the power of language and give voice to middle managers who are key actors when implementing integrated care.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"75 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86285961","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 patient experience of telehealth access and clinical encounters in Australian health care during COVID-19: implications for enhancing integrated care","authors":"Jennifer White, J. Byles, T. Walley","doi":"10.1108/jica-05-2021-0024","DOIUrl":"https://doi.org/10.1108/jica-05-2021-0024","url":null,"abstract":"PurposeTelehealth consultations are likely to continue while living with COVID-19 and the risk of other pandemics. Greater understanding of patient perceptions is important in order to inform future integrated care models involving telehealth.Design/methodology/approachAn interpretative qualitative study. Fifteen, in-depth qualitative interviews were conducted with diverse range of community dwelling patients who attended outpatient clinics at The John Hunter Hospital, Newcastle. Data were analysed using an inductive thematic approach.FindingsKey themes were identified: (1) telehealth is valuable in a pandemic; (2) telehealth accessibility can be challenging; (3) there are variations in care experiences, especially when visual feedback is lacking; (4) telehealth for acute and complex care needs may lead to gaps and (5) considerations towards the future of telehealth, beyond a pandemic.Research limitations/implicationsThere is a shortfall in evidence of the patient experience of integrated care within a telehealth framework. The results provided practical insights into how telehealth services can play a greater role in integrated care.Practical implicationsApart from the need for affordable access to high-speed data for basic Internet access, the author posit the need for patient and clinician training towards promoting communication that is underpinned by choice, trust and shared decision-making.Originality/valueTelehealth is important towards keeping patients safe during COVID-19. Key findings extend knowledge of the practical implications need to promote integrated telehealth systems. While there is a benefit in extending telehealth to more preventative activities, there is also a need for greater service coordination and sharing of information between treating clinicians. Overall the results highlight telehealth consultations to be an effective means of treating well-known conditions and for follow-up rather than for acute conditions.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"32 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87071238","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":"Transferable learning about patient and public involvement and engagement in gambling support services from health and social care: findings from a narrative review and workshop with people with lived experience","authors":"C. Norrie, Stephanie Bramley, Valerie Lipman, J. Manthorpe","doi":"10.1108/jica-06-2021-0030","DOIUrl":"https://doi.org/10.1108/jica-06-2021-0030","url":null,"abstract":"PurposeThe involvement of patients or members of the public within public health, health and social care and addictions services is growing in the UK and internationally but is less common in gambling support services. The purpose of this study was to explore Patient and Public Involvement (PPI) infrastructures and engagement channels used in health and care services and debate their transferability to the gambling support sector (including research, education and treatment).Design/methodology/approachA narrative review examined data from six English language electronic databases, NHS evidence and grey literature covering the period 2007–2019. We identified 130 relevant items from UK literature. A workshop was held in London, England, with people with lived experience of gambling harm to seek their views on and applicability of the review findings to gambling services.FindingsSynthesis of literature and workshop data was undertaken. Main themes addressed “What works” in relation to: building infrastructures and organising involvement of people with lived experience; what people want to be involved in; widening participation and sustaining involvement and respecting people with lived experience.Practical implicationsExamination of the literature about involvement and engagement of patients, service users and the public in public health, health and social care and addiction services provides potentially useful examples of good practice which may be adopted by gambling services.Originality/valueThe involvement of people with lived experience of gambling harms in gambling support services is under-explored, with little published evidence of what constitutes good practice amongst self-organising groups/networks/grassroots organisations or rights-based/empowerment-based approaches.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"218 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79740138","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":"Translating research into health practice: a case study of integrated palliative care system in Catalonia, Spain","authors":"Meritxell Mondejar-Pont, X. Gómez-Batiste, Anna Ramon-Aribau","doi":"10.1108/jica-06-2021-0032","DOIUrl":"https://doi.org/10.1108/jica-06-2021-0032","url":null,"abstract":"PurposeResearch findings provide the professional community with knowledge that enables to better understand healthcare interventions. Many authors point out that whilst these findings are valued, the findings are not always translated into healthcare practise. The purpose of the paper is to assess the applicability of the essential elements of an integrated palliative care system (IPCS) found in research into the practise of Osona Palliative Care System (OPCS).Design/methodology/approachThe study used a qualitative methodology with a case study design. In total, 24 health professionals were interviewed in Osona for the research, and the results were analysed using deductive content analysis.FindingsThe study concludes that research findings can better be translated into specific contexts by incorporating the needs and characteristics of the system. The process could be a strategy for bridging the research–practise gap.Originality/valueCombining the findings from the study and the findings found in the literature reviewed led to the creation of the IPCS-elements-blended model of research and practise. Such a kind of mixed model could be used in other studies seeking to overcome the research and practice gap.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"41 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90869743","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":"Link workers, activities and target groups in social prescribing: a literature review","authors":"Denis Rothe, Raffael Heiss","doi":"10.1108/jica-09-2021-0047","DOIUrl":"https://doi.org/10.1108/jica-09-2021-0047","url":null,"abstract":"Purpose Social prescribing is a model of integrated care, in which primary healthcare staff can link patients to the social care sector. However, social prescribing can occur in different forms. To better understand the concept of social prescribing, this literature review examines the role of the link workers, activities and target groups.Design/methodology/approach A literature review was conducted. Studies before May 2020 were considered. In total, 1,700 studies were identified using the databases Pubmed, PsycInfo, Cinahl, Web of Science and Cochrane Library. After eligibility checks, 16 studies were included in the final analysis.Findings A few studies warned of a deeper engagement of the link worker due to service dependency, but most studies encouraged an active and supportive role of the link worker. Participants engaged in social, physical and counseling activities. The majority of studies emphasized the importance of linking group activities with personal preferences and identity needs. The main target groups were composed of individuals with psychosocial needs, but some studies also included patients with physical or mental illnesses.Originality/value Social prescribing is widely advocated as an innovative model of integrated care. However, few studies have looked into the complex system of social prescribing. This study analyzes the linking processes, activities and target groups in extant social prescribing programs.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"238 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73265193","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 European Health Data Space: a step towards digital and integrated care systems","authors":"Stefano Genovese, R. Bengoa, J. Bowis, M. Harney, Bastian Hauck, Michel Pinget, Mike Leers, Tarja Stenvall, N. Guldemond","doi":"10.1108/jica-11-2021-0059","DOIUrl":"https://doi.org/10.1108/jica-11-2021-0059","url":null,"abstract":"PurposeThe COVID-19 pandemic has demonstrated the urgency of better chronic disease management and the importance of making it an integral part of the recovery agenda in Europe. This paper aims to explore the shift towards digital and integrated care systems in Europe.Design/methodology/approachIn this viewpoint paper the Expert Group for Integrated Care and Digital Health Europe (EGIDE) group argues that an orchestrated shift towards integrated care holds the solution to the chronic disease pandemic.FindingsThe development of integrated care cannot happen without shifting towards a digitalised healthcare system via large-scale initiatives like the European Health Data Space (EHDS) and the involvement of all stakeholders.Originality/valueThe EGIDE group has identified some foundational principles, which can guide the way to realise the full potential of the EHDS for integrated care and can support the involved stakeholders’ thinking.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"16 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87252263","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":"Auditing integrated stroke care to support quality improvement activities: development of a peer-to-peer audit framework","authors":"B. Buijck, B. Vrijhoef, Monique Bergsma, D. Dippel","doi":"10.1108/jica-06-2021-0033","DOIUrl":"https://doi.org/10.1108/jica-06-2021-0033","url":null,"abstract":"PurposeTo organize stroke care, multiple stakeholders work closely together in integrated stroke care services (ISCS). However, even a well-developed integrated care program needs a continuous quality improvement (CQI) cycle. The current paper aims to describe the development of a unique peer-to-peer audit framework, the development model for integrated care (DMIC), the Dutch stroke care standard and benchmark indicators for stroke.Design/methodology/approachA group of experts was brought together in 2016 to discuss the aims and principles of a national audit framework. The steering group quality assurance (SGQA) consisted of representatives of a diversity of professions in the field of stroke care in the Netherlands, including managers, nurses, medical specialists and paramedics.FindingsAuditors, coordinators and professionals evaluated the framework, agreed on that the framework was easy to use and valued the interesting and enjoyable audits, the compliments, feedback and fruitful insights. Participants consider that a quality label may help to overcome necessity issues and have health care insurers on board. Finally, a structured improvement plan after the audit is needed.Originality/valueAn audit offers fruitful insights into the functioning of an ISCS and the collaboration therein. Best practices and points of improvement are revealed and can fuel collaboration and the development of partnerships. Innovative cure and care may lead to an increasing area of support among professionals in the ISCS and consequently lead to improved quality of delivered stroke care.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"40 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90272879","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}