Integrated care for community dwelling older Australians

2019 ◽  
Vol 27 (2) ◽  
pp. 173-187 ◽  
Author(s):  
Jennifer Mann ◽  
Sue Devine ◽  
Robyn McDermott
Keyword(s):  
Public Policy ◽  
Health System ◽  
Integrated Care ◽  
Scoping Review ◽  
Older Persons ◽  
Community Dwelling ◽  
Older Person ◽  
Content Type

PurposeIntegrated care is gaining popularity in Australian public policy as an acceptable means to address the needs of the unwell aged. The purpose of this paper is to investigate contemporary models of integrated care for community dwelling older persons in Australia and discuss how public policy has been interpreted at the service delivery level to improve the quality of care for the older person.Design/methodology/approachA scoping review was conducted for peer-reviewed and grey literature on integrated care for the older person in Australia. Publications from 2007 to present that described community-based enablement models were included.FindingsCare co-ordination is popular in assisting the older person to bridge the gap between existing, disparate health and social care services. The role of primary care is respected but communication with the general practitioner and introduction of new roles into an existing system is challenging. Older persons value the role of the care co-ordinator and while robust model evaluation is rare, there is evidence of integrated care reducing emergency department presentations and stabilising quality of life of participants. Technology is an underutilised facilitator of integration in Australia. Innovative funding solutions and a long-term commitment to health system redesign is required for integrated care to extend beyond care co-ordination.Originality/valueThis scoping review summarises the contemporary evidence base for integrated care for the community dwelling older person in Australia and proposes the barriers and enablers for consideration of implementation of any such model within this health system.

scholarly journals OPEN ARCH: integrated care at the primary–secondary interface for the community-dwelling older person with complex needs

2020 ◽  
Vol 26 (2) ◽  
pp. 104
Author(s):  
Jennifer Mann ◽  
Rachel Quigley ◽  
Desley Harvey ◽  
Megan Tait ◽  
Gillian Williams ◽  
...  
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Older Persons ◽  
Healthcare Delivery ◽  
Community Dwelling ◽  
Ageing Population ◽  
Preventative Care ◽  
Older Person ◽  
Complex Needs ◽  
Open Arch

Optimal care of community-dwelling older Australians with complex needs is a national imperative. Suboptimal care that is reactive, episodic and fragmented, is costly to the health system, can be life threatening to the older person and produces unsustainable carer demands. Health outcomes would be improved if services (health and social) are aligned towards community-based, comprehensive and preventative care. Integrated care is person-focussed in outlook and defies a condition-centric approach to healthcare delivery. Integration is a means to support primary care, with the volume and complexity of patient needs arising from an ageing population. Older Persons Enablement and Rehabilitation for Complex Health Conditions (OPEN ARCH) is a targeted model of care that improves access to specialist assessment and comprehensive care for older persons at risk of functional decline, hospitalisation or institutionalised care. OPEN ARCH was developed with primary care as the central integrating function and is built on four values of quality care: preventative health care provided closer to home; alignment of specialist and generalist care; care coordination and enablement; and primary care capacity building. Through vertical integration at the primary–secondary interface, OPEN ARCH cannot only improve the quality of care for clients, but improves the capacity of primary care to meet the needs of this population.

A network of networks

2017 ◽  
Vol 31 (2) ◽  
pp. 223-236 ◽  
Author(s):  
Rick Iedema ◽  
Raj Verma ◽  
Sonia Wutzke ◽  
Nigel Lyons ◽  
Brian McCaughan
Keyword(s):  
Health Service ◽  
Health System ◽  
Network Governance ◽  
System Reform ◽  
System Transformation ◽  
Content Type ◽  
Multiple Networks ◽  
Network Of Networks

Purpose To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI), and the multiple networks and enabling resources that it encompasses, govern, manage and extend the potential of networks for healthcare practice improvement. Design/methodology/approach This is a case study investigation which took place over ten months through the first author’s participation in network activities and discussions with the agency’s staff about their main objectives, challenges and achievements, and with selected services around the state of New South Wales to understand the agency’s implementation and large system transformation activities. Findings The paper demonstrates that ACI accommodates multiple networks whose oversight structures, self-organisation and systems change approaches combined in dynamic ways, effectively yield a diversity of network governances. Further, ACI bears out a paradox of “centralised decentralisation”, co-locating agents of innovation with networks of implementation and evaluation expertise. This arrangement strengthens and legitimates the role of the strategic hybrid – the healthcare professional in pursuit of change and improvement, and enhances their influence and impact on the wider system. Research limitations/implications While focussing the case study on one agency only, this study is unique as it highlights inter-network connections. Contributing to the literature on network governance, this paper identifies ACI as a “network of networks” through which resources, expectations and stakeholder dynamics are dynamically and flexibly mediated and enhanced. Practical implications The co-location of and dynamic interaction among clinical networks may create synergies among networks, nurture “strategic hybrids”, and enhance the impact of network activities on health system reform. Social implications Network governance requires more from network members than participation in a single network, as it involves health service professionals and consumers in a multi-network dynamic. This dynamic requires deliberations and collaborations to be flexible, and it increasingly positions members as “strategic hybrids” – people who have moved on from singular taken-as-given stances and identities, towards hybrid positionings and flexible perspectives. Originality/value This paper is novel in that it identifies a critical feature of health service reform and large system transformation: network governance is empowered through the dynamic co-location of and collaboration among healthcare networks, particularly when complemented with “enabler” teams of people specialising in programme implementation and evaluation.

Great minds think alike: does leader-follower similarity in construal level of the work enhance leader-member exchange quality?

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sevgi Emirza ◽  
Alev Katrinli
Keyword(s):  
Mental Representation ◽  
Current Knowledge ◽  
Interpersonal Relationship ◽  
Survey Study ◽  
Construal Level ◽  
Leader Member Exchange ◽  
Content Type ◽  
Member Exchange

PurposeThe purpose of this study is to investigate whether leader-follower similarity in construal level of the work, which indicates the degree of abstraction applied to mental representation of the work, influences the quality of interpersonal relationship at work.Design/methodology/approachFirst, an interview study was conducted to adapt the work-based construal-level (WBCL) scale. Then, a survey study was conducted for hypothesis testing. Data collected from 245 matched supervisor-subordinate dyads were analyzed using multi-level modeling.FindingsResults revealed that dyadic similarity in work-domain construal level is positively related to leader-member exchange (LMX) quality. As a leader and a follower become similar to each other in terms of mental representation (i.e. construal level) of work, they experience higher relationship quality.Originality/valueThis study enhances the current knowledge of the role of cognition and cognitive similarity in leadership processes.

The role of transformative healthcare technology on quality of life during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammad Asif Salam ◽  
Saleh Bajaba
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Saudi Arabia ◽  
Service Delivery ◽  
Health Care System ◽  
Service System ◽  
Content Type ◽  
Care System

Purpose The purpose of this study is to investigate the role of the COVID-19 health-care system quality (HSQ) and its impact on the individual (satisfaction) and social (quality of life [QOL]) outcomes in the context of a transformative health-care delivery system using service-dominant logic (SDL). Design/methodology/approach A sample consisting of 1,008 individuals who have experienced the COVID-19 health-care system was drawn from four different regions of Saudi Arabia using the simple random sampling technique. The survey was conducted using an online survey and 1,008 respondents answered, based on their experience and knowledge of the COVID-19 health-care system. Partial least squares structural equation modeling was applied to test the proposed research model. Findings The study findings suggest that service system satisfaction (SAT) significantly mediates the role of the HSQ in delivering and enhancing the QOL. HSQ also has a significant role to play on the SAT as well as the QOL. These findings contribute to the body of knowledge on SDL in the context of HSQ in understanding the significant role of technologies can play in enhancing service satisfaction and better QOL during a crisis such as COVID-19. This study also improves the understanding of the importance of customer-centricity, real-time visibility through tracking and tracing of service flow, agile decision-making, fewer but better-defined service objectives, and finally shaping mindsets and behaviors of all the relevant parties involved in the HSQ service delivery process. Research limitations/implications One of the major limitations of this study is that, although COVID-19 is an ongoing global pandemic, cross-sectional data were collected in only one country. The findings may not be generalizable across subsequent waves of the pandemic. The best practices of HSQ could be studied around the globe and the results used to support continuous improvement. Originality/value This study advances the understanding of the SDL in the context of a transformative health-care system for a transitional economy by focusing on individual and social well-being during an unexpected crisis such as the COVID-19 pandemic. This study also contributes toward the understanding of the roles of enabling technologies to improve the service delivery system which results in an improved SAT, as well as better QOL for the society at large. Based on SDL this research validates the HSQ model, relevant measures and its overall impact on SAT and QOL in the context of a transformative health-care service system in Saudi Arabia.

scholarly journals Economical effect on doubling of COVID-19 cases: examples of rich versus poor countries

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Osama Ali Maher ◽  
Dmitry Mun ◽  
Fatma Giha ◽  
Mayouson Ali ◽  
Saverio Bellizzi
Keyword(s):  
Health System ◽  
Work Force ◽  
Epidemiological Data ◽  
Content Type ◽  
Poor Countries ◽  
Complex Emergencies ◽  
Internal Conflicts ◽  
Comprehensive Comparison ◽  
The Government

Purpose The paper aims to examine some economical, political and health system indicators on the transmission of the COVID-19 transmission within the national system. The main objective is to investigate what are the most effective indicators which have led to the declared numbers by countries. Design/methodology/approach This study combined multiple sets of data to describe best the economical status of the health system including the government spending on the health system to draw some conclusion regarding the behavior of the pandemic. Findings Complex emergencies and internal conflicts negatively affected the quality of the reported cases and the size of the pandemic. The health work force was the most determinant factor of the health system. It can sometimes be impossible to understand the epidemic only with epidemiological data or health system one; economical aspects of health system and political situation have to be added to the equation. Originality/value The research according to the authors’ knowledge is the most comprehensive comparison so far that investigate the non-covid aspects from a political side in particular in complex emergencies and war situation added health system indicators.

scholarly journals An Association of Quality of Life and Ageing Perceptions Among Community Dwelling Older Adults in Uganda

2021 ◽  
Author(s):  
Joy Louise -Onoria ◽  
Raymond Odokonyero ◽  
Bruno Giordani ◽  
Dickens Akena ◽  
Emmanuel Mwesiga ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Persons ◽  
Low Cost ◽  
Well Being ◽  
The Elderly ◽  
Community Dwelling ◽  
Life Questionnaire ◽  
Social Activities ◽  
Positive Perception

Abstract Background: Uganda’s population, though, largely characterized by young people, has seen the number of people aged 60 and over grow from 686,000 twenty years ago, to 1,433,596 in 2014. Effective caring for the well-being of this population requires strategic and deliberate planning that involves quality of life (QoL) assessments. QoL assessments among the elderly are important in evaluating the efficacy of strategies, such as health interventions, welfare programs, health care, and well-being of the elderly. However, elderly in Uganda face several challenges, ranging from loneliness, poor housing, lack of social and financial support, and poor health. These may negatively affect older persons’ quality of life and consequently their perceptions and attitudes towards aging. Methods: The study was carried out in 2019 in the communities of Nansana and Busukuma town councils in Wakiso district, Uganda. The participants were 380 people 60 years and older. To establish the association between perceptions of ageing and QoL, this study utilized a locally adapted version of the Older Person’s Quality of Life Questionnaire (OPQOL) and the Brief Ageing Perceptions Questionnaire (B-APQ). The OPQOL assesses three domains of QoL: Health QoL (HQoL); Social economic QoL (SQoL); and Psychosocial QoL (PQoL). The B-APQ assesses perceptions about physical age, participation in social activities, and perceptions about ability to regulate emotions as one ages. Pearson’s Chi-square tests were used to characterize the relationship between the perceptions and quality of life.Results: The majority of the respondents, 61% (95%CI 56.7-64.8), had negative perceptions towards ageing. Eighty six percent had poor HQoL, 90% poor SQoL and 83% poor PQoL. There was a significant association between good HQoL and positive perception about participation in social activities (X2 = 7.3670, P = 0.007) as well as with positive perception on regulation of emotions (X2 = 18.1803, P<0.001). There was a significant association between good SQoL and positive perception about participation in social activities (X2 = 5.3472, P = 0.021), as well with positive perception on regulation of emotions (X2 = 10.5128, P<0.001). A significant association between good PQoL and positive perception on regulation of emotions (X2 = 9.2414, P= 0.002).Conclusion: Positive perceptions of ageing are associated with good QoL. Directly addressing perceptions of ageing could be a low cost and effective strategy to improve the QoL of older persons in SSA

scholarly journals Understanding coaching efficacy in education through activity systems: privileging the nuances of provision

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rachel M. Lofthouse ◽  
Anthea Rose ◽  
Ruth Whiteside
Keyword(s):  
Activity Systems ◽  
Content Type ◽  
Coaching Efficacy ◽  
Range Of Functions ◽  
Cultural Historical Activity ◽  
The Individual ◽  
Specific Challenge

PurposeThe research demonstrates the role of activity systems based in Cultural Historical Activity Theory as a means of analysing characteristics and efficacy of specific provisions of coaching in education.Design/methodology/approachThree examples of coaching in education were selected, involving 51 schools in England. The three examples were re-analysed using activity systems. This drew on existing evaluation evidence, gathered through interviews, questionnaires, focus groups and recordings of coaching.FindingsIn each example, the object of the coaching was to address a specific challenge to secure the desired quality of education. Using activity systems it is possible to demonstrate that coaching has a range of functions (both intended and consequential). The individual examples illustrate the potential of coaching to support change in complex and diverse education settings.Research limitations/implicationsThe use of existing data from evaluations means that direct comparisons between examples are not made. While data were collected throughout the duration of each coaching programme no follow-up data was available.Practical implicationsThe analysis of the examples of coaching using activity systems provides evidence of the efficacy of specific coaching provision in achieving individually defined objectives related to sustaining and improving specific educational practices.Originality/valueThe research offers insights into how coaching in education might be better tuned to the specific needs of contexts and the challenges experienced by the individuals working in them. In addition, it demonstrates the value of activity systems as an analytical tool to make sense of coaching efficacy.

Mapping the contours of fairness

2014 ◽  
Vol 1 (2) ◽  
pp. 191-204 ◽  
Author(s):  
Lilian Otaye ◽  
Wilson Wong
Keyword(s):  
Job Satisfaction ◽  
Factor Analysis ◽  
Regression Analysis ◽  
Turnover Intention ◽  
Content Type ◽  
Mediating Role ◽  
The Uk ◽  
The Relationship

Purpose – The purpose of this paper is to explore the contours of fairness by showing how different facets of fairness impact three important employee outcomes (job satisfaction, turnover intention and employer advocacy) and examining the mediating role of quality of management and leadership (through perceptions of both senior management and the quality of exchange with immediate supervisors) in attenuating negative impacts of unfairness on these outcomes. The study extends the concept of fairness beyond the traditional focus on organizational justice and models the mediating role of leadership on the relationship between (un)fairness and the three employee-level outcomes in a sample of employees representative of the UK workforce. Design/methodology/approach – Data were obtained from a nationally representative sample of 2,067 employees in the UK. Exploratory factor analysis and then confirmatory factor analysis is used to refine three unfairness factors and address their dimensionality of the unfairness scale and then multiple regression analysis is used to test a fairness-leadership-employee performance outcome model. Findings – Results of multiple regression analysis revealed that both trust in leadership and leader-member exchange partially mediate the relationship between organizational (un)fairness and job satisfaction, advocacy and turnover intention, respectively. Practical implications – The findings highlight the important role that leaders play in influencing the relationship between perception of unfairness and employee outcomes. This has implications for both theory and practice as it suggests that the pattern of inclusion that leaders create through the relationships that they develop with their followers has a significant impact on the relationship between unfairness and the work outcomes. They not only must manage traditional perceptions of justice, but also the assessments employees make about trust in management judgements and the perceived consequences of such judgements. Originality/value – In an environment where perceptions of unfairness are becoming both more endemic but also more complex, the study shows that both senior leaders and immediate supervisors have important agency in managing negative consequences. Through the measurement of satisfaction, turnover intention and employer advocacy it also provides potential links to link fairness into the engagement literature.

The mediating role of organizational embeddedness on the relationship between quality of work life and turnover

2017 ◽  
Vol 38 (5) ◽  
pp. 696-711 ◽  
Author(s):  
Decha Dechawatanapaisal
Keyword(s):  
Life Quality ◽  
Work Life ◽  
Quality Of Work Life ◽  
Content Type ◽  
Mediating Role ◽  
Career Opportunities ◽  
Organizational Embeddedness ◽  
The Relationship

Purpose The purpose of this paper is to investigate the mediating effect of organizational embeddedness in the relationship between quality of work life (QWL) and turnover under a foundation of conservation of resources theory. Design/methodology/approach Data were collected from 422 healthcare professionals through a questionnaire survey, and analyzed by means of a confirmatory factor analysis and structural equation modeling. Findings The results indicate that organizational embeddedness has a negative impact on employees’ intention to leave, and on actual turnover. For QWL perception, career opportunities, work life balance, and job characteristics are positive and significant predictors of organizational embeddedness. In addition, organizational embeddedness plays an intermediary role that mediates the relationship between the three components of QWL mentioned earlier and turnover intention, and also between the factor of career opportunities and actual turnover. Research limitations/implications The current research took place within two healthcare organizations. Replicating the study in a variety of business sectors or professions with a larger sample of subjects would be useful for the generalizability of the findings. Practical implications Organizations may improve their retention of employees by offering intrinsic resources that can be obtained from the social contexts of the individual through human resource management system, e.g., growth opportunities, a healthy and caring work life quality. Such motivational resources then develop a sense of obligation toward their places of employment, which influences their intention to stay or leave. Originality/value This study examines the mediating role of organizational embeddedness between employees’ perception of their work life quality and their desire and behavior to withdraw, which is an area of inquiry that has not been fully investigated in the literature.

Restaurant and foodservice research

2017 ◽  
Vol 29 (4) ◽  
pp. 1203-1234 ◽  
Author(s):  
Robin DiPietro
Keyword(s):  
Past Research ◽  
Future Research ◽  
Research Papers ◽  
Content Type ◽  
The Past ◽  
Restaurant Management ◽  
Foodservice Industry ◽  
Future Direction

Purpose The purpose of this paper is to present a review of the foodservice and restaurant literature that has been published over the past 10 years in the top hospitality and tourism journals. This information will be used to identify the key trends and topics studied over the past decade, and help to identify the gaps that appear in the research to identify opportunities for advancing future research in the area of foodservice and restaurant management. Design/methodology/approach This paper takes the form of a critical review of the extant literature that has been done in the foodservice and restaurant industries. Literature from the past 10 years will be qualitatively assessed to determine trends and gaps in the research to help guide the direction for future research. Findings The findings show that the past 10 years have seen an increase in the number of and the quality of foodservice and restaurant management research articles. The topics have been diverse and the findings have explored the changing and evolving segments of the foodservice industry, restaurant operations, service quality in foodservice, restaurant finance, foodservice marketing, food safety and healthfulness and the increased role of technology in the industry. Research limitations/implications Given the number of research papers done over the past 10 years in the area of foodservice, it is possible that some research has been missed and that some specific topics within the breadth and depth of the foodservice industry could have lacked sufficient coverage in this one paper. The implications from this paper are that it can be used to inform academics and practitioners where there is room for more research, it could provide ideas for more in-depth discussion of a specific topic and it is a detailed start into assessing the research done of late. Originality/value This paper helps foodservice researchers in determining where past research has gone and gives future direction for meaningful research to be done in the foodservice area moving forward to inform academicians and practitioners in the industry.

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