Care integration as means for developing efficiency in budget constraints

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Sinervo
Keyword(s):  
Social Services ◽  
Middle Managers ◽  
Organizational Structures ◽  
Care Quality ◽  
Budget Constraints ◽  
Good Basis ◽  
Joint Management ◽  
Care Integration ◽  
Health And Social Care ◽  
Increase Efficiency

Abstract Background Care integration has been an aim in government policies since 2000s in Finland. In 8 counties municipalities have created regional joint health and social care authorities in responsibility of all health and social services to boost service integration. Joint management gives possibilities to change organizational structures and organizing care paths in new ways. Most of these joint authorities suffer from severe budget constraints and layoffs has been done. Care integration has been seen as alleviating in budget constraints and to increase efficiency. In this study the views of top and middle managers and personnel on care integration as means to develop efficiency is explored. Methods A large, newly established joint authority of 200000 inhabitants participated the study. The joint authority had a large gap in its budget, hence layoffs were planned. We compiled a data of regional policy documents, carried out individual and group interviews of management (21) and a survey to employees (N = 2047). In the interviews, views of top and middle managers on how efficiency should be developed and on views of care integration in relation to efficiency were studied. The views of employees were explored in the survey. Results The joint authority was launched in a very short time and care paths were not planned before the organizational change. The managers saw that siloed practices created inefficiency and care integration increasing efficiency although the research evidence was seen insufficient. In the survey the views of the employees of developing efficiency and care quality were more negative than managers. Both groups, however saw that care integration was underdeveloped. Developing integration especially at primary level became also a key strategy of the joint authority. Conclusions Joint management creates a good basis for integration. The implementation of care integration, however, requires managers' collaboration and organisational culture supporting integration. Key messages In managers views care integration can increase efficiency. Joint management is a good basis for integration, but care processes have to be planned.

Case definition for health and social care services integrated initiatives

2019 ◽  
Vol 27 (4) ◽  
pp. 264-275 ◽  
Author(s):  
Siu Mee Cheng ◽  
Cristina Catallo
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Literature Search ◽  
Social Care ◽  
Case Definition ◽  
Content Type ◽  
Health And Social Services ◽  
Care Integration ◽  
Health And Social Care ◽  
Integrated Health

Purpose The purpose of this paper is to develop a case definition of integrated health and social services initiatives that serve older adults, and will provide characteristics to aid in the identification of such initiatives. The case definition is intended to ease the identification of integrated health and social care initiatives. Design/methodology/approach A limited search was undertaken of both scientific and gray literature that documented and/or examined integrated health and social services initiatives. In addition, literature on well-documented and generally accepted integrated healthcare and social services models that reflect collaborations from healthcare and social services organizations that support older adults was also used to develop the case definition. Findings The case definition is as follows: healthcare organizations from across the continuum of care working together with social services organizations, so that services are complementary and coordinated in a seamless and unified system, with care continuity for the patient/client in order to achieve desired health outcomes within a holistic perspective; the initiatives comprise at least one healthcare organization and one social care organization; and these initiatives possess 18 characteristics, grouped under 9 themes: patient care approach; program goals; measurement; service and care quality; accountability and responsibility; information sharing; culture; leadership; and staff and professional interaction. Research limitations/implications A limitation of this study is that the characteristics are based on a limited literature search. The quality of some of the literature both gray and published was not definitive: information on how they undertook the literature search was not provided; exclusion and inclusion criteria were not included; and there was insufficient detail on the design of the studies included. Furthermore, the literature reviews are based on integrated initiatives that target both seniors and non-senior’s based services. The cross-section of initiatives studied is also different in scale and type, and these differences were not explored. Practical implications The case definition is a useful tool in aiding to further the understanding of integrated health and social care initiatives. The number of definitions that exist for integrated health and social care initiatives can make it confusing to clearly understand this field and topic. The characteristics identified can assist in providing greater clarity and understanding on health and social care integration. Originality/value This study provides greater coherence in the literature on health and social care integration. It aids in better framing the phenomenon of healthcare and social services integration, thereby enhancing understanding. Finally, the study provides a very useful and concrete list of identifying characteristics, to aid in identifying integrated health and social care initiatives that serve older adults.

The complexity of social work at hospitals during the pandemic in Germany

2021 ◽  
Vol 36 (5) ◽  
pp. 5-19
Author(s):  
Anna Bocheńska-Brandt
Keyword(s):  
Social Work ◽  
Social Services ◽  
Social Life ◽  
Hospital Staff ◽  
Community Services ◽  
Steady Increase ◽  
Holistic View ◽  
Hygiene Measures ◽  
Health And Social Care ◽  
Protection Legislation

Social work is also an indispensable pillar in the healthcare of patients in hospitals (Homfeldt, 2012, p. 489). Hospital social services support patients in processing stressful diagnoses and coping with the consequences of diseases (Gödecker-Geenen, 2005, p. 19). Due to the current development of problem situations and the current structure of health and social care, social work is gaining more and more importance (Schaub, 2008, p. 17; Hofmann, 2004, p. 413). Demographic changes result in an increase in the number of elderly people and a steady increase in their life expectancy. The lack of family or financial resources creates gaps in the supply of hospital social services (Meyer, 2019, p. 9). However, the change in the spectrum of health risks and diseases from predominantly acute to chronic ones, justifies the importance of social work in these facilities (Schaub, 2008, p. 17; Lützenkirchen, 2005, pp. 10–14). The Covid-19 pandemic presents a particular challenge that has spread around the world since late 2019. It affects all areas of life and life situations (Schmitt, 2020, p. 177). Protective measures to contain the virus, such as mass gathering prohibitions, contact restrictions, minimum distance regulations, hygiene measures and masks, determine daily and social life. Preventing visits from relatives, pastors and social workers puts a new light on the holistic view of health and the disease and its social determinants (Kröll et al., 2020, pp. 7–38). Infection protection legislation also restricts community services from interacting with patients and hospital staff. Work processes and communication must change, and existing systems must be redesigned (Truell, 2020).

scholarly journals Web Search Engines - Not Yet a Reliable Replacement for Bibliographic Databases

2018 ◽  
Vol 13 (3) ◽  
pp. 85-87
Author(s):  
Emma Hughes
Keyword(s):  
Social Sciences ◽  
Social Services ◽  
Search Engines ◽  
English Language ◽  
Web Search ◽  
Boolean Logic ◽  
Bibliographic Databases ◽  
Quality Of Reporting ◽  
Health And Social Care ◽  
Web Search Engines

A Review of: Bates, J., Best, P., McQuilkin, J., & Taylor, B. (2017) Will web search engines replace bibliographic databases in the systematic identification of research? The Journal of Academic Librarianship, 43(1), 8-17. https://doi.org/10.1016/j.acalib.2016.11.003 Abstract Objective - To explore whether web search engines could replace bibliographic databases in retrieving research. Design - Systematic review. Setting - English language articles in health and social care; comparing bibliographic databases and web search engines for retrieving research published between January 2005 and August 2015, in peer-reviewed journals and available in full-text. Subjects - Eight bibliographic databases: ASSIA (Applied Social Sciences Index and Abstracts), CINAHL Plus (Cumulative Index to Nursing and Allied Health Literature), LISA (Library and Information Science Abstracts), Medline, PsycInfo, Scopus, SSA (Social Services Abstracts), and SSCI (Social Sciences Citation Index) and five web search engines: Ask, Bing, Google, Google Scholar, Yahoo. Methods - A literature search via the above bibliographic databases and web search engines. The retrieved results were independently appraised by two researchers, using a combination of tools and checklists, including the PRESS checklist (McGowan et al., 2016) and took guidance on developing search strategies from the Centre for Reviews and Dissemination (2009). Main Results - Sixteen papers met the appraisal requirements. Each paper compared at least one bibliographic database against one web-search engine. The authors also discuss findings from their own search process. Precision and sensitivity scores from each paper were compared. The results highlighted that web search engines do not necessarily use Boolean logic and in general have limited functionality compared to bibliographic databases. There were variances in the way precision scores were calculated between papers, but when based on the first 100 results, web search engines were similar to some databases. However, their sensitivity scores were much weaker. Conclusion - Whilst precision scores were strong for web search engines, sensitivity was lacking; therefore web search engines cannot be seen as a replacement for bibliographic databases at this time. The authors recommend improving the quality of reporting in studies regarding literature searching in academia in order for reliable comparisons to be made.

scholarly journals Frailty and social support: the care services response to aging in Russia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Kholostov
Keyword(s):  
Social Support ◽  
Social Services ◽  
New Technologies ◽  
Effective Interaction ◽  
Well Being ◽  
The Elderly ◽  
The State ◽  
Institutional Perspective ◽  
Term Care ◽  
Health And Social Care

Abstract In the twenty-first century, ageing of population, having become a global phenomenon, raised questions about the need to consider the social services of the elderly from an institutional perspective. Thus, the number of Russians over the age of 100 in 2018 exceeded 15.7 thousand people. In Moscow, as in the mega polis, in 2018 more than 3.4031 million people (27.2%) are older than working age. Different countries have their own characteristics of social service systems, models and policies, it depends to a large extent on the traditions of assistance, sources of financing, the space of responsibility assumed by the State, society, the family and the individual himself. New technologies to be applied for working with the elderly in Russia. Transition to the establishment of a system of long-term care at the level of multidisciplinary cooperation (reform of the residential care system; development of community based services, formation of Social Support Services for 75+, foster family for the elderly).Development of active longevityChanging the role repertoire of an older person (formation of new types of social roles previously characteristic of younger ages; changing of intergenerational link formats, etc.).The growing social responsibility of the State contributes to a more effective interaction between health and social care authorities, as well as a more active involvement of the NGO sector in addressing the problems of older persons.The increase in the number of older persons leads to the creation and active development of a silver economy that contributes to improving the well-being of people.Transfer of retraining and advanced training systems to the competent level according to professional standards (independent assessment of qualifications, personnel diagnostics, formation of individual trajectory of education, training of multiple disciplinary teams).

scholarly journals Organization of Medical-Social Services for the Elderly Internally Displaced persons from the ATO Zones at the Level of Primary Medico-Sanitary Care

2021 ◽  
pp. 47-55
Author(s):  
Vera Chaykovska ◽  
Tatiyana Vialykh ◽  
Nataliya Velichko ◽  
Vadim Tolstikh ◽  
Svitlana Moskaliuk ◽  
...  
Keyword(s):  
Medical Care ◽  
Social Services ◽  
Social Protection ◽  
The Elderly ◽  
Psychological Characteristics ◽  
Term Care ◽  
Family Doctors ◽  
Internally Displaced ◽  
Health And Social Care

This paper is concerned with the organizationofmedical-socialservicesfortheelderly internally displaced personsfrom theATO zonesat the level of primary medico-sanitary aid.Sociologicalinvestigationsusingpersonal questionnairesandexperts’evaluationshave shown thatsocial-psychological characteristics oftheelderlyinternallydisplacedpersons(IDPs),Theirsocialadaptation, inadequatefinancingandlowlevelofmedico-socialcare,as well as their preferences make it necessary organize healthmonitoringsystem, treatment, rehabilitation and long-term care by family doctors, information centres, day-time stayand rehabilitation centres.WehavedevelopedthemodeloforganizingambulatoryservicesfortheelderlyIDPsat the level of primarymedico-socialcare(PMSC)that would include structural modernization and optimization of its optimal provision. Inouropinion, thismodelismostaccessibleandeconomicallygrounded. It allowsprovide interaction and co-operation of the professionals of health and social care institutions, optimization of standards and principles of medical care. Implementationofthismodelasmostaccessibleandeconomicallygroundedwould allowinteractionandcooperationoftheprofessionalsofhealthcareorganizationsandsocialprotectionsettings.Introductionofthismodel,asmostaccessibleandeconomicallygrounded,would allowensureinteractionandcooperationoftheprofessionalsofhealthcareand social protection institutions, optimizeobservation of the medical care standards and principles. Wehavedevelopedmethodologicalapproachesfortrainingthephysiciansandhealthcare-giversreceivingkeyknowledgeanddeveloping self-carehabitsfortheelderlyIDPsattheir homesconsideringtheirmedico-socialandpsychologicalneeds.

scholarly journals Mental wellbeing in doctors: the measure matters! development of a core outcome set for measuring wellbeing in doctors

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S235-S236
Author(s):  
David Baldwin ◽  
Aimee O'Neill ◽  
Julia Sinclair ◽  
Gemma Simons
Keyword(s):  
Health Education ◽  
Delphi Study ◽  
Research Policy ◽  
Core Outcome Set ◽  
Care Quality ◽  
Mental Wellbeing ◽  
Medical Council ◽  
Core Outcome ◽  
Outcome Set ◽  
Health And Social Care

AimsTo achieve a consensus Core Outcome Set for measuring mental wellbeing in doctors.Hypothesis: A minimum set of valid, reliable and practical wellbeing measures is needed for doctors.BackgroundThe importance of doctors’ mental wellbeing to everyone using Health Care is highlighted by the levels of burnout reported in doctors around the world. In 2019 a number of UK policy documents made recommendations for the wellbeing of doctors, but how those wellbeing interventions are evaluated needs to be defined. Core Outcome Sets are increasingly being used in medicine to prevent waste in research, by recommending the inclusion of a minimum set of valid, reliable and practical measures. An operational definition and Core Outcome Set for wellbeing in doctors is needed to meaningfully progress the work in this field.MethodThe Centre for Workforce Wellbeing (C4WW), a collaboration between the University of Southampton and Health Education England, was created to support research into the nature, assessment and enhancement of wellbeing in physicians. A Systematic Review of wellbeing measures used in doctors and the robustness of those measures, along with surveys of 250 UK doctors of all grades and specialities and patient and public involvement is informing what a core outcome set could be. A Delphi Study among 37 UK experts has been initiated to establish the consensus Core Outcome Set.ResultPublication of research into doctors’ wellbeing is growing internationally. In the UK alone data are being captured by multiple national organisations including: the Care Quality Commission, General Medical Council, British Medical Association and the Royal Colleges. Health and Social Care Organisations are, therefore, keen to “do something” and are spending money on wellbeing interventions with little, or no, evidence base and a lack of appropriate, comparable evaluation. A Core Outcome Set for measuring wellbeing in doctors is ethically required to reduce waste, to replace burnout measures and to refine wellbeing interventions.ConclusionWellbeing measures that actually measure wellbeing, and not burnout, which are validated, reliable and practical, are needed to inform local organisational, national government and international research policy. An absence of burnout does not equate to wellbeing. The focus of measurement needs to shift to capture in what contexts we thrive, not just survive. If everyone used the same Core Outcome Set to measure mental wellbeing, direct comparisons could be made, and money invested, in creating infrastructure, processes and cultures that really work.Health Education England funded PhD.

scholarly journals Exploiting Administrative Data to Understand the Mental Health of Children Known to Social Services

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Sarah McKenna ◽  
Aideen Maguire ◽  
Dermot O'Reilly
Keyword(s):  
Mental Health ◽  
General Population ◽  
Health Outcomes ◽  
Social Services ◽  
Social Care ◽  
Mental Health Outcomes ◽  
Health And Social Care ◽  
Self Harm ◽  
Children In Care ◽  
Care System

Background Research has consistently found a high prevalence of mental ill-health among children in out-of-home care. However, results have varied significantly by study location, type of care intervention, sample population and mental health measurement, and concerns have been raised about appropriate reference populations. In addition, little is known about children known to social services who remain with their birth families. Aim To examine mental ill-health amongst children known to social services based on care exposure including those who remain at home, those placed in foster care, kinship care or institutional care and the general population not known to social services. Methods Northern Ireland is unique in that has an integrated health and social care system and holds data centrally on all children known to social services. Social services data (1995-2015) will be linked to hospital discharge data (2010-2015), prescribed medication data (2010-2015), self-harm data (2010-2015) and death records (2010-2015) to investigate mental health outcomes in terms of psychiatric hospital admissions, psychotropic medication uptake, self-harm and suicide. Results Data cleaning has been completed and analysis is underway. Preliminary results will be available by December 2019. Descriptive statistics will provide a mental health profile of children in care compared not only to children in the general population but to those who are known to social services but remain in their own home. Regression models will determine which factors are most associated with poor mental health outcomes. Conclusion This project is the UK’s first population-wide data linkage study examining the mental health of children in the social care system, including looked-after children and those known to social services who remain in their own home. Project partners in the Department of Health recognise the potential of these findings to inform future policy relating to targeting interventions for children in receipt of social care services.

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