scholarly journals O3-01-03: IMPLEMENTATION OF AN INTEGRATED CARE PATHWAY FOR DEMENTIA IN THE CLINICAL PRACTICE: RATIONALE, DESIGN, AND METHODOLOGY-THE REMIND STUDY

2014 ◽  
Vol 10 ◽  
pp. P207-P208 ◽  
Author(s):  
Graziella Filippini
2020 ◽  
Author(s):  
Sara Morris ◽  
Sadie Geraghty ◽  
Deborah Sundin

BACKGROUND The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. OBJECTIVE This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech birth in Western Australia and professional recommendations regarding the care of women experiencing breech presentation close to or at term. This study was designed to inform the development of an integrated care pathway for women experiencing a breech presentation. This mixed methods approach situated within the pragmatic paradigm was determined to be the optimal way for incorporating multidisciplinary recommendations with current clinical practice guidelines and consumer feedback. METHODS A mixed methods study utilizing semistructured interviews, an electronic Delphi (e-Delphi) study, and clinical practice guideline appraisal was conducted to generate new data. The interviews were designed to provide insights and understanding of the experiences of women in Western Australia who are diagnosed with a breech presentation. The e-Delphi study explored childbirth professionals’ knowledge, opinions, and recommendations for the care of women experiencing breech presentation close to or at term. The clinical practice guideline appraisal will examine the current national and professional breech management and care guidelines. This study has the potential to highlight areas in practice that may need improvement and enable clinicians to better support women through what can be a difficult time. RESULTS Data collection for this study began in November 2018 and concluded in March 2020. Data analysis is currently taking place, and the results will be disseminated through publication when the analysis is complete. CONCLUSIONS The results of this study will guide the development of an integrated care pathway for women experiencing a breech presentation close to or at term, with the hope of moving toward standardized breech care for women in Western Australia. This study protocol has the potential to be used as a research framework for future studies of a similar nature. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/23514


10.2196/23514 ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. e23514 ◽  
Author(s):  
Sara Morris ◽  
Sadie Geraghty ◽  
Deborah Sundin

Background The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. Objective This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech birth in Western Australia and professional recommendations regarding the care of women experiencing breech presentation close to or at term. This study was designed to inform the development of an integrated care pathway for women experiencing a breech presentation. This mixed methods approach situated within the pragmatic paradigm was determined to be the optimal way for incorporating multidisciplinary recommendations with current clinical practice guidelines and consumer feedback. Methods A mixed methods study utilizing semistructured interviews, an electronic Delphi (e-Delphi) study, and clinical practice guideline appraisal was conducted to generate new data. The interviews were designed to provide insights and understanding of the experiences of women in Western Australia who are diagnosed with a breech presentation. The e-Delphi study explored childbirth professionals’ knowledge, opinions, and recommendations for the care of women experiencing breech presentation close to or at term. The clinical practice guideline appraisal will examine the current national and professional breech management and care guidelines. This study has the potential to highlight areas in practice that may need improvement and enable clinicians to better support women through what can be a difficult time. Results Data collection for this study began in November 2018 and concluded in March 2020. Data analysis is currently taking place, and the results will be disseminated through publication when the analysis is complete. Conclusions The results of this study will guide the development of an integrated care pathway for women experiencing a breech presentation close to or at term, with the hope of moving toward standardized breech care for women in Western Australia. This study protocol has the potential to be used as a research framework for future studies of a similar nature. International Registered Report Identifier (IRRID) DERR1-10.2196/23514


2021 ◽  
Vol 79 ◽  
pp. S295
Author(s):  
R. Giles ◽  
K. Dreijerink ◽  
R.S. Van Leeuwaarde ◽  
A.N. Van Der Horst-Schrivers ◽  
T.P. Links

Author(s):  
Roelof Ettema ◽  
Goran Gumze ◽  
Katja Heikkinen ◽  
Kirsty Marshall

BackgroundCare recipients in care and welfare are increasingly presenting themselves with complex needs (Huber et al., 2016). An answer to this is the integrated organization of care and welfare in a way that personalized care is the measure (Topol, 2016). The reality, however, is that care and welfare are still mainly offered in a standardized, specialized and fragmented way. This imbalance between the need for care and the supply of care not only leads to under-treatment and over-treatment and thus to less (experienced) quality, but also entails the risk of mis-treatment, which means that patient safety is at stake (Berwick, 2005). It also leads to a reduction in the functioning of citizens and unnecessary healthcare cost (Olsson et al, 2009).Integrated CareIntegrated care is the by fellow human beings experienced smooth process of effective help, care and service provided by various disciplines in the zero line, the first line, the second line and the third line in healthcare and welfare, as close as possible (Ettema et al, 2018; Goodwin et al, 2015). Integrated care starts with an extensive assessment with the care recipient. Then the required care and services in the zero line, the first line, the second line and / or the third line are coordinated between different care providers. The care is then delivered to the person (fellow human) at home or as close as possible (Bruce and Parry, 2015; Evers and Paulus, 2015; Lewis, 2015; Spicer, 2015; Cringles, 2002).AimSupport societal participation, quality of live and reduce care demand and costs in people with complex care demands, through integration of healthcare and welfare servicesMethods (overview)1. Create best healthcare and welfare practices in Slovenia,  Poland, Austria, Norway, UK, Finland, The Netherlands: three integrated best care practices per involved country 2. Get insight in working mechanisms of favourable outcomes (by studying the contexts, mechanisms and outcomes) to enable personalised integrated care for meeting the complex care demand of people focussed on societal participation in all integrated care best practices.3. Disclose program design features and requirements regarding finance, governance, accountability and management for European policymakers, national policy makers, regional policymakers, national umbrella organisations for healthcare and welfare, funding organisations, and managers of healthcare and welfare organisations.4. Identify needs of healthcare and welfare deliverers for creating and supporting dynamic partnerships for integrating these care services for meeting complex care demands in a personalised way for the client.5. Studying desired behaviours of healthcare and welfare professionals, managers of healthcare and welfare organisations, members of involved funding organisations and national umbrella organisations for healthcare and welfare, regional policymakers, national policy makers and European policymakersInvolved partiesAlma Mater Europaea Maribor Slovenia, Jagiellonian University Krakow Poland, University Graz Austria, Kristiania University Oslo Norway, Salford University Manchester UK, University of Applied Sciences Turku Finland, University of Applied Sciences Utrecht The Netherlands (secretary), Rotterdam Stroke Service The Netherlands, Vilans National Centre of Expertise for Long-term Care The Netherlands, NIVEL Netherlands Institute for Health Services Research, International Foundation of Integrated Care IFIC.References1. Berwick DM. The John Eisenberg Lecture: Health Services Research as a Citizen in Improvement. Health Serv Res. 2005 Apr; 40(2): 317–336.2. Bruce D, Parry B. Integrated care: a Scottish perspective. London J Prim Care (Abingdon). 2015; 7(3): 44–48.3. Cringles MC. Developing an integrated care pathway to manage cancer pain across primary, secondary and tertiary care. International Journal of Palliative Nursing. 2002 May 8;247279.4. Ettema RGA, Eastwood JG, Schrijvers G. Towards Evidence Based Integrated Care. International journal of integrated care 2018;18(s2):293. DOI: 10.5334/ijic.s22935. Evers SM, Paulus AT. Health economics and integrated care: a growing and challenging relationship. Int J Integr Care. 2015 Jun 17;15:e024.6. Goodwin N, Dixon A, Anderson G, Wodchis W. Providing integrated care for older people with complex needs: lessons from seven international case studies. King’s Fund London; 2014.7. Huber M, van Vliet M, Giezenberg M, Winkens B, Heerkens Y, Dagnelie PC, Knottnerus JA. Towards a 'patient-centred' operationalisation of the new dynamic concept of health: a mixed methods study. BMJ Open. 2016 Jan 12;6(1):e010091. doi: 10.1136/bmjopen-2015-0100918. Lewis M. Integrated care in Wales: a summary position. London J Prim Care (Abingdon). 2015; 7(3): 49–54.9. Olsson EL, Hansson E, Ekman I, Karlsson J. A cost-effectiveness study of a patient-centred integrated care pathway. 2009 65;1626–1635.10. Spicer J. Integrated care in the UK: variations on a theme? London J Prim Care (Abingdon). 2015; 7(3): 41–43.11. Topol E. (2016) The Patient Will See You Now. The Future of Medicine Is in Your Hands. New York: Basic Books.


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