Professionals’ views on integrated care

2017 ◽  
Vol 25 (4) ◽  
pp. 247-255 ◽  
Author(s):  
Outi Jolanki ◽  
Liina-Kaisa Tynkkynen ◽  
Timo Sinervo

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.

2016 ◽  
Vol 24 (4) ◽  
pp. 225-232 ◽  
Author(s):  
Carolina Baltar Day ◽  
Regina Rigatto Witt ◽  
Nelly D Oelke

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.


2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.


2021 ◽  
Vol 27 (1) ◽  
pp. 57
Author(s):  
Ailsa Munns

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.


2007 ◽  
Vol 12 (1) ◽  
Author(s):  
Norah L Katende-Kyenda ◽  
Martie S Lubbe ◽  
Jan HP Serfontein ◽  
Ilse Truter

The aim of this study was to investigate the prescribing of antimicrobials in private primary health care in South Africa. ABSTRAK Die doel met hierdie studie was om die voorskryfpatrone van antimikrobiese middels in private primêre gesondheidsorginrigtings in Suid-Afrika te ondersoek.


Author(s):  
Nita Arisanti ◽  
Dany Hilmanto ◽  
Elsa Pudji Setiawati ◽  
Veranita Pandia

.................... The access to palliative care in ends of life is one of the patients’ rights. Therefore it should be delivered into every level of health care for patients and family members. In some countries, palliative care is more frequent delivered in hospitals compare to primary health care, even though primary health care has a significant role in providing palliative care. Most families prefer to care for patients at home rather than in the hospital................................... The implementation of palliative care in Indonesia is still very limited to certain hospitals, even though doctors in primary care have great potential to offer such care to people in the community. Some of the factors contributing to the implementation are cultural and socioeconomic factors, patient and family perceptions, attitudes of service providers, lack of trained personnel, distribution of palliative care units, lack of consolidation and limited funds. As a result, patients with end-stage disease die in hospitals without receiving palliative care or dying at home with inadequate support................


Author(s):  
Cláudia Chaves ◽  
João Duarte ◽  
Odete Amaral ◽  
Emília Coutinho ◽  
Paula Nelas

Abstract.Introduction: Patient satisfaction is an essential indicator for assessment of the quality of care and there is evidence of its correlation with health outcomes. Satisfaction with health care is a multidimensional concept which considers aspects such as access, organization and patient-professional interactions. We believe that the nursing care, in particular, are critical in the health/disease process.Objectives: Validate a scale to assess the satisfaction of users with regard to nursing care, adapted from EUROPEP instrument and assess the satisfaction of users of the primary health care of the central region of Portugal.Methods: Cross-sectional study with a sample of 827 adult users (female 64.4%) with a mean age of 50,08±18,58 years. Data were collected through a questionnaire consisting of socio-demographic variables, the instrument EUROPEP (Ferreira, 1995) to assess satisfaction with primary health care and to assess satisfaction specifically with the nursing team we have created issues grouped in the help relationship, interpersonal and instrumental dimension. Internal consistency, reproducibility and content analysis were evaluated using the SPSS 23.0; considering the consistency acceptable to an α of Cronbach’s alpha > 0.70. The coefficient for each item is presented with a confidence interval of 95%.Results: In all dimensions of EUROPEP questionnaire, the highest percentage of satisfaction with the care was between "good" and "very good". The dimensions created to evaluate specifically the nursing care showed a Cronbach's alpha coefficient of α total of 0.972.Conclusions: These results suggest that the dimensions created to evaluate nursing care will be useful for research on the Portuguese population. User satisfaction is crucial to the quality and efficiency of care, requiring the commitment of all service providers on implementation of systematic management practices leading to satisfaction, giving particular attention to the continuous improvement of organizational processes.Keywords: Patient satisfaction; primary health care; nursing care, adult, PortugalResumo.SATISFAÇÃO DOS UTENTES DOS CUIDADOS DE SAÚDE PRIMÁRIOS COM OS CUIDADOS DE ENFERMAGEM – AMOSTRA DA REGIÃO CENTRO DE PORTUGALIntrodução: A satisfação dos doentes constitui um indicador indispensável para a avaliação da qualidade dos cuidados e há evidência da sua correlação com os resultados em saúde. A satisfação com os cuidados de saúde é um conceito multidimensional que considera aspetos como acesso, organização e interação doente - profissional. Consideramos que os cuidados de enfermagem, em particular, são fundamentais no processo saúde/doença.Objetivos: Validar uma escala para avaliar a satisfação dos utentes face aos cuidados de enfermagem, adaptado do instrumento EUROPEP e avaliar a satisfação dos utentes dos cuidados de saúde primários da região centro de Portugal.Material e métodos: Estudo transversal, com uma amostra de 827 utentes adultos (maioria do sexo feminino 64,4%) com uma média de idade de 50,08±18,58 anos. Os dados foram recolhidos através de um questionário, constituído por variáveis sociodemográficas, o instrumento EUROPEP (Ferreira, 1995) para avaliar a satisfação com os cuidados de saúde primários e para avaliar a satisfação especificamente com a equipa de enfermagem elaboramos questões adaptadas do instrumento EUROPEP e agrupadas nas dimensões relação de ajuda, dimensão interpessoal e instrumental. A consistência interna, reprodutibilidade e análise de conteúdo foram avaliados com recurso ao SPSS 23.0; considerando a consistência aceitável para um de Cronbach > 0,70. O coeficiente para cada item é apresentado com um intervalo de confiança de 95%.Resultados: Em todas as dimensões do questionário EUROPEP, a maior percentagem de satisfação com os cuidados situou-se entre “boa” e “muito boa”. As dimensões criadas para avaliar especificamente os cuidados de enfermagem apresentaram um coeficiente de α de Cronbach total de 0,972.Conclusões: Estes resultados sugerem que as dimensões criadas para avaliar os cuidados de enfermagem serão úteis para a investigação na população Portuguesa. A satisfação do utente é decisiva para a qualidade e eficiência dos cuidados prestados, sendo necessário o compromisso de todos os prestadores na implementação de práticas sistemáticas de gestão que conduzam à satisfação, dando particular atenção à melhoria contínua dos processos organizacionais.Palavras-chave: Satisfação dos Utentes; cuidados de saúde primários, cuidados de enfermagem, adulto, Portugal


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Phaksachiphon Khanthong ◽  
Chatchadapon Chaiyasat ◽  
Chayada Danuwong

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.


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