Integrated care transitions: emergency to primary health care

2016 ◽  
Vol 24 (4) ◽  
pp. 225-232 ◽  
Author(s):  
Carolina Baltar Day ◽  
Regina Rigatto Witt ◽  
Nelly D Oelke
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Integrated Care ◽  
Care Transitions ◽  
Large City ◽  
University Hospital ◽  
Structured Interviews ◽  
Content Type ◽  
Primary Health ◽  
Shared Information

Purpose – The purpose of this paper is to focus on the Integrated Care Transitions Project between the emergency department (ED) of a university hospital and primary health care (PHC) services in a large city in Southern Brazil was the focus of this study. Care transitions occurred through telephone contact for patients discharged from the ED to PHC. Design/methodology/approach – This descriptive, exploratory qualitative research collected data via semi-structured interviews (n=14) including interns of health disciplines, advisors for interns, nurses, and physicians from the ED and PHC Family Unit. A thematic analysis of the data were conducted. Findings – ED providers felt they gained increased knowledge of the care networks available for patients in the community. Connection between the providers in ED and PHC facilitated confidence in the services provided in the community and increased continuity of care for patients’ needs. The PHC providers recognized integration promoted communication and better care planning for patients discharged from ED. Integrated care made the work in the PHC easier and benefited the users. Research limitations/implications – The study evaluated a program available in one hospital. Generalizability may be limited as services in the ED were provided by professional residents and their advisors, not employees of the hospital. Practical implications – Shared information by different health services leads to better care for patients and greater job satisfaction for providers. Originality/value – Care transitions are not well-managed in health care; there is limited research focusing on care transitions from ED to community. For providers and patients, this program assisted in building capacity and networks for transitions in care.

Information technology and knowledge sharing for better health care: an emerging economy context

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lejla Turulja ◽  
Merima Cinjarevic ◽  
Ljiljan Veselinovic
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Knowledge Sharing ◽  
Health Care Professionals ◽  
Primary Data ◽  
Future Research ◽  
Structured Interviews ◽  
Content Type ◽  
Primary Health ◽  
Information And Communication

Purpose The present study aims to explore “what” type of knowledge is shared, “how” it is shared and what information and communication tools are used to share knowledge among health-care professionals in the context of emerging “digital laggard” country in the South-Eastern European region (i.e. Bosnia and Herzegovina [B&H]). Design/methodology/approach This study applies the qualitative research methodology and thematic analysis for collecting, analysing and interpreting data. Primary data is collected using semi-structured interviews (n = 9). Key informants are employees of the main primary health-care institution in the capital of B&H. Findings The results indicate that knowledge sharing among primary health-care practitioners is the interplay of formal and informal exchange of knowledge, facilitated by both traditional communication media (face-to-face interaction) and ICT-based tools. In regards to ICT tools, our findings suggest that instant messing applications (predominantly Viber) are viewed as common media for sharing tacit knowledge within a community of practice. Research limitations/implications This study is limited to one emerging digital laggard country; thus, future research regarding ICT-based knowledge sharing in other emerging digital laggard countries is welcomed. Originality/value In the context of “digital laggard”, societies, informal, spontaneous and dynamic system of social interactions can be a successful substitute for ICT-based formalised and structured system of knowledge sharing.

Professionals’ views on integrated care

2017 ◽  
Vol 25 (4) ◽  
pp. 247-255 ◽  
Author(s):  
Outi Jolanki ◽  
Liina-Kaisa Tynkkynen ◽  
Timo Sinervo
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Integrated Care ◽  
Information Exchange ◽  
Service Providers ◽  
Patient Choice ◽  
Content Type ◽  
Health Care Clinics ◽  
Primary Health ◽  
Health And Social Care

Purpose Integrated care policies have been at the heart of recent health reforms in many European countries. The purpose of this paper is to study the integration from the perspective of health care personnel working in primary health care clinics. Design/methodology/approach The study employs data from interviews collected in a research project examining patient choice and integrated care in primary health care clinics in Finland. The interviews were conducted in five cities in Southern Finland in 17 primary health care clinics in Autumn 2014. Among the interviewees there were both doctors (n=32) and nurses (n=31). Findings The typical problems hindering integration were, according to the workers, poor communication and insufficient information exchange between professionals, unclear definition of responsibilities between professionals, and lacking contacts and information exchange between health and social care professionals. To secure availability and continuity of care, doctors and nurses did extra work and exceeded their duties or invented ad hoc solutions to solve the problem at hand. According to professionals, patients were forced to take an active role as coordinator of their own care when responsibilities were not clearly defined between professionals. Originality/value This paper highlights that successful integration requires taking into account the requirements of the day-to-day work of health care clinics, and clarifying what facilitates and what hinders practical collaboration between different actors in health care and between health care and other service providers.

The challenges of providing primary health care to Afghan immigrants in Tehran: a key global human right issue

2020 ◽  
Vol 13 (3) ◽  
pp. 259-273 ◽  
Author(s):  
Afsaneh Takbiri ◽  
AmirHossein Takian ◽  
Abbas Rahimi Foroushani ◽  
Ebrahim Jaafaripooyan
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Insurance Coverage ◽  
Structured Interviews ◽  
Human Right ◽  
Content Type ◽  
Primary Health ◽  
Afghan Immigrants

Purpose This study aims to explore the challenges of providing primary health care (PHC) to Afghan immigrants in Tehran as an important global human right issue. Design/methodology/approach In this exploratory study, a total of 25 purposively selected PHC providers, including physicians, psychologists and midwives, were approached for face-to-face, semi-structured interviews, lasting 30 min on average. Thematic analysis was used to analyze the data. Findings The most common challenges of providing PHC to Afghan immigrants were categorized at individual, organizational and societal levels. Communication barriers and socioeconomic features emerged at the individual level. The organizational challenges included mainly the lack of insurance coverage for all immigrants and the lack of a screening system upon the immigrants’ arrival from the borders. At the societal level, the negative attitudes toward Afghan immigrants were causing a problematic challenge. Research limitations/implications The main limitation was the possibility that only health-care professionals with particular positive or negative perspectives about immigrants enter into the study, because of the voluntary nature of participation. Practical implications Findings can help policymakers adopt evidence-informed strategies for facilitating PHC provision and improving the access to health care in immigrants as a global human right concern. Social implications This study alerts about undesirable consequences of certain attitudes and behaviors of the society toward immigrant health. Originality/value To the best of the authors’ knowledge, this is one of the first studies conducted in PHC centers in Tehran Province that explores the challenges of providing PHC to Afghan immigrants.

scholarly journals A Protocol on Using the RE-AIM Framework in the Process Evaluation of the Primary Health Integrated Care Project for Four Chronic Conditions in Kenya

2022 ◽  
Vol 9 ◽  
Author(s):  
Violet Naanyu ◽  
Hillary Koros ◽  
Beryl Maritim ◽  
Jemima Kamano ◽  
Kenneth Too ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Integrated Care ◽  
Process Evaluation ◽  
Secondary Data ◽  
Management Program ◽  
Primary Data ◽  
Breast Cancers ◽  
Structured Interviews ◽  
Primary Health

Background: There has been a rapid increase in morbidity and mortality arising from non-communicable diseases (NCDs). The Academic Model Providing Access to Healthcare (AMPATH) program has established a chronic disease management program in collaboration with the Ministry of Health (MoH) in Kenya at over 150 health facilities in western Kenya. The primary health integrated care for chronic (PIC4C) disease project seeks to deliver preventive, promotive, and curative care for diabetes, hypertension, cervical and breast cancers at the primary health care level. We apply the RE-AIM framework to conduct a process evaluation of the integrated PIC4C model. This paper describes the protocol we are using in the PIC4C process evaluation planning and activities.Methods and Analysis: This evaluation utilizes clinic reports as well as primary data collected in two waves. Using mixed methods (secondary data, observation, semi-structured interviews, and focus group discussions), the process evaluation assesses the reach, effectiveness, adoption, implementation and maintenance of the PIC4C model in Busia and Trans Nzoia Kenya. The evaluation captures the PIC4C process, experiences of implementers and users, and the wishes of those using the PIC4C services. We will analyse our data across the RE-AIM dimensions using descriptive statistics and two-sample t-test to compare the mean scores for baseline and end line. Qualitative data will be analyzed thematically.Discussion: The process evaluation of the PIC4C model in Kenya allows implementers and users to reflect and question its implementation, uptake and maintenance. Our experiences thus far suggest practicable strategies to facilitate primary health care can benefit extensively from deliberate process evaluation of the programs undertaken. Furthermore, integrating the RE-AIM framework in the process evaluation of health programs is valuable due to its pragmatic and reporting usefulness.

scholarly journals Modeling of Food and Nutrition Surveillance in Primary Health Care

2017 ◽  
Vol 30 (1) ◽  
pp. 109-126 ◽  
Author(s):  
Santuzza Arreguy Silva VITORINO ◽  
Marly Marques da CRUZ ◽  
Denise Cavalcante de BARROS
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care System ◽  
Document Analysis ◽  
Logic Model ◽  
Structured Interviews ◽  
Primary Health ◽  
Food And Nutrition ◽  
Definition Of ◽  
Care System

ABSTRACT Objective: To describe the modeling stages of food and nutrition surveillance in the Primary Health Care of the Unified Health Care System, considering its activities, objectives, and goals Methods: Document analysis and semi-structured interviews were used for identifying the components, describe the intervention, and identify potential assessment users. Results: The results include identification of the objectives and goals of the intervention, the required inputs, activities, and expected effects. The intervention was then modeled based on these data. The use of the theoretical logic model optimizes times, resources, definition of the indicators that require monitoring, and the aspects that require assessment, identifying more clearly the contribution of the intervention to the results Conclusion: Modeling enabled the description of food and nutrition surveillance based on its components and may guide the development of viable plans to monitor food and nutrition surveillance actions so that modeling can be established as a local intersectoral planning instrument.

scholarly journals Lessons learnt from CBR practice at Hua Don Primary Health Care, Thailand

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Phaksachiphon Khanthong ◽  
Chatchadapon Chaiyasat ◽  
Chayada Danuwong
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Leader ◽  
Second Phase ◽  
Target Area ◽  
Content Type ◽  
Community Based Research ◽  
Primary Health ◽  
Lessons Learnt ◽  
Essential Skills

PurposeThe purpose of this study is to determine the capacity map of professional learning community (PLC) practicing community-based research (CBR) in Ubon Ratchathani Rajabhat University, Thailand, and the implementation of the lessons learnt from the process and essential skills at Hua Don Primary Health Care (PHC).Design/methodology/approachParticipatory action research (PAR) design was conducted in two phases, one on campus and the other in the PHC. For gathering and validating the data, the snowball sampling technique, focus group, in-depth interviews and the triangulation method were used.FindingsThe PLC capacity map from the first phase provided the essential skills of CBR and the second phase revealed lessons learnt from the implementation in the Hua Don PHC. The shortcut in researching a new target area by a collaboration of the community leader and village health volunteers was prominent. The results could be interpreted in creating collaboration in health care with a new community.Originality/valueThe capacity map is a practical guideline for a beginner or CBR novice researcher, and the lessons learnt help the implementation in the health field, particularly in PHC, succeed smoothly.

Evaluation of integrated antenatal care implementation in primary health care

2020 ◽  
Vol 28 (2) ◽  
pp. 99-117 ◽  
Author(s):  
Sandra Hakiem Afrizal ◽  
Achmad Nizar Hidayanto ◽  
Putu Wuri Handayani ◽  
Besral Besral ◽  
Evi Martha ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antenatal Care ◽  
Local Governments ◽  
Health Workers ◽  
Practical Implication ◽  
Functional Integration ◽  
Content Type ◽  
Primary Health

PurposeThis study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.Design/methodology/approachAn exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.FindingsThe results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.Research limitations/implicationsThe contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.Practical implicationsPractical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.Originality/valueSince only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.

scholarly journals Prevalence and profile of daily smokers seen at three primary health care units in Pelotas, southern Brazil

2012 ◽  
Vol 34 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Mariane Ricardo Acosta Lopez ◽  
Karen Jansen ◽  
Luciano Dias de Mattos Souza ◽  
Ricardo Tavares Pinheiro ◽  
Elaine Tomasi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Total Sample ◽  
Tobacco Consumption ◽  
University Hospital ◽  
Daily Smoking ◽  
Southern Brazil ◽  
Cross Sectional ◽  
Primary Health ◽  
Significant Difference

Objectives: To estimate the prevalence of daily smoking among users of three primary health care units affiliated with a university hospital in the municipality of Pelotas, southern Brazil, and to identify factors associated with daily tobacco consumption. Methods: This cross-sectional study included all individuals over 14 years of age who sought treatment at the health care units between June 29, 2009, and February 23, 2010, and lived in the area covered by the unit. Interviews were conducted during home visits to collect data on sociodemographic characteristics and health behaviors; the Mini International Neuropsychiatric Interview (MINI) was used to assess the presence of mood disorders; and a question from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) on the daily use of tobacco in the past 3 months was used to assess smoking. Results: The total sample comprised 1,848 individuals, mostly female (72.9%), aged between 46 and 60 years (28.5%), and belonging to socioeconomic class C (61%). The prevalence of daily smoking was 23.4% (n = 432), and there was a statistically significant difference between men and women: 27 vs. 22.1% (p < 0.050). Conclusion: Our findings confirm a high prevalence of smoking among users of primary health care units, underscoring the need for a more accurate process of diagnosis and treatment at these facilities.

scholarly journals Continuity of nursing care in Finnish primary health care settings: A 15-year follow-up

2018 ◽  
Vol 7 (1) ◽  
pp. 11 ◽  
Author(s):  
Risto Raivio ◽  
Eija Paavilainen ◽  
Kari J. Mattila
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuity Of Care ◽  
Nursing Care ◽  
Health Centre ◽  
University Hospital ◽  
Primary Health ◽  
Patient Reported ◽  
Health Centres

Objective: Continuity is an essential part of high-quality nursing care. This study is the first systematic follow-up of Finnish primary health care patients assessing continuity of health centre nursing staff. The aim was to ascertain how longitudinal interpersonal continuity of care is related to patients’ characteristics, their consultation experiences, and how continuity had changed over the 15-year study period.Methods: A questionnaire survey was conducted among patients attending the health centres in the Tampere University Hospital catchment area from 1998 to 2013. A total of 157,549 patients responded out of 363,464 in almost 60 health centres. We analysed the opinions of patients (n = 47,470) who had visited a nurse during the survey weeks. Opinions on the continuity of care were assessed with the question: “When visiting the health centre, do you usually see the same nurse”, the alternatives being “yes” or “no”. A binary logistic regression model was used.Results: Almost two thirds of the respondents had met the same nurse when visiting their health care centre. Longitudinal interpersonal continuity of care decreased by 15 percentage (67%-52%) during the study years. Continuity was connected to patient-related items such as a visit in the preceding 12 months (OR 1.32, 95% CI 1.17-1.49) and non-urgency of the visit (OR 1.44, 95% CI 1.27-1.63). The most prominent factor contributing to the sense of continuity of care was how attentively nurses had listened to their patients’ problems and shown an interest in them and a willingness to answer their questions (OR 1.31, 95% CI 1.120-1.43).Conclusions: In the past 15 years patient-reported longitudinal interpersonal continuity of nursing care has declined. However continuity of care proved to enhance the experienced quality of primary health care. Continuity was best realized in nursing care when nurses had listened to their patients’ problems, showed interest toward them and a willingness to answer their questions.

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