Adoption of care management activities by primary care nurses for people with common mental disorders and physical conditions: a multiple case study

2021 ◽  
Author(s):  
Ariane Girard ◽  
Édith Ellefsen ◽  
Pasquale Roberge ◽  
Joëlle Bernard‐Hamel ◽  
Catherine Hudon
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Care Management ◽  
Common Mental Disorders ◽  
Multiple Case Study ◽  
Physical Conditions ◽  
Primary Care Nurses ◽  
Multiple Case

scholarly journals An Embedded Multiple Case Study: Facilitating Uptake of Food Insecurity Screening Initiatives in Low Resource Primary Care Settings

2021 ◽  
Author(s):  
Sabira Taher ◽  
Naoko Muramatsu ◽  
Angela Odoms-Young ◽  
Nadine Peacock ◽  
Michael C. Fagen ◽  
...  
Keyword(s):  
Primary Care ◽  
Food Insecurity ◽  
Multiple Case Study ◽  
Food Assistance ◽  
Screening Tools ◽  
Implementation Barriers ◽  
Program Fidelity ◽  
Number Of Patients ◽  
Multiple Case

Abstract Background Food insecurity (FI), limited access to healthy food, is a social determinant of health linked to poor dietary health and difficulty with disease management. Healthcare experts support the adoption of validated screening tools within primary care clinics to identify and connect FI patients to food resources. Yet, a lack of standard practices limits uptake. The purpose of this study was to understand program processes and outcomes of primary care focused FI screening initiatives that can guide wide-scale program implementation. Methods This was an embedded multiple case study of two primary care-focused initiatives implemented in two diverse health systems in Chicago and Suburban Cook County that routinely screened patients for FI and referred them to onsite food assistance programs. The Consolidated Framework for Implementation Research and an iterative process were used to collect/analyze qualitative data through semi-structured interviews with N = 19 clinical staff. Intended program activities, outcomes, actors, implementation barriers/facilitators and overarching implementation themes were identified as a part of a cross-case analysis. Findings: Programs outcomes included: the number of patients screened and identified as FI; the number of patients referred to and participated in the onsite food assistance program. Overall, neither case achieved intended reach or participation. Limited financial, human and infrastructure support were implementation barriers. Existing community collaborations and clinic-level autonomy were critical facilitators during implementation that contributed to the flexibility of program activities. Programs were tailored to each context to assist in implementation feasibility, but contributed to low program fidelity. Conclusions Programs were highly adaptable and each context enhanced implementation feasibility across settings. These characteristics have the potential to support program uptake in other settings, but should be used with caution to preserve program fidelity and to achieve intended outcomes. A foundational model for the development and testing of standard clinical practice was the product of this study.

Observation of interprofessional collaboration in primary care practice: A multiple case study

2016 ◽  
Vol 30 (6) ◽  
pp. 787-794 ◽  
Author(s):  
Susan Pullon ◽  
Sonya Morgan ◽  
Lindsay Macdonald ◽  
Eileen McKinlay ◽  
Ben Gray
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Interprofessional Collaboration ◽  
Multiple Case Study ◽  
Care Practice ◽  
Multiple Case

scholarly journals Longitudinal multiple case study on effectiveness of network-based dementia care towards more integration, quality of care, and collaboration in primary care

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198811 ◽  
Author(s):  
Anke Richters ◽  
Minke S. Nieuwboer ◽  
Marcel G. M. Olde Rikkert ◽  
Rene J. F. Melis ◽  
Marieke Perry ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Multiple Case Study ◽  
Dementia Care ◽  
Multiple Case

scholarly journals Implementation of cancer screening in rural primary care practices after joining an accountable care organisation: a multiple case study

2021 ◽  
Vol 9 (4) ◽  
pp. e001326
Author(s):  
Heather Nelson-Brantley ◽  
Edward F Ellerbeck ◽  
Stacy McCrea-Robertson ◽  
Jennifer Brull ◽  
Jennifer Bacani McKenney ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Multiple Case Study ◽  
Accountable Care ◽  
Rural Primary Care ◽  
Care Organisation ◽  
Multiple Case ◽  
Care Practices ◽  
Primary Care Practices

ObjectiveTo describe common strategies and practice-specific barriers, adaptations and determinants of cancer screening implementation in eight rural primary care practices in the Midwestern United States after joining an accountable care organisation (ACO).DesignThis study used a multiple case study design. Purposive sampling was used to identify a diverse group of practices within the ACO. Data were collected from focus group interviews and workflow mapping. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection and analysis. Data were cross-analysed by clinic and CFIR domains to identify common themes and practice-specific determinants of cancer screening implementation.SettingThe study included eight rural primary care practices, defined as Rural-Urban Continuum Codes 5–9, in one ACO in the Midwestern United States.ParticipantsProviders, staff and administrators who worked in the primary care practices participated in focus groups. 28 individuals participated including 10 physicians; one doctor of osteopathic medicine; three advanced practice registered nurses; eight registered nurses, quality assurance and licensed practical nurses; one medical assistant; one care coordination manager; and four administrators.ResultsWith integration into the ACO, practices adopted four new strategies to support cancer screening: care gap lists, huddle sheets, screening via annual wellness visits and information spread. Cross-case analysis revealed that all practices used both visit-based and population-based cancer screening strategies, although workflows varied widely across practices. Each of the four strategies was adapted for fit to the local context of the practice. Participants shared that joining the ACO provided a strong external incentive for increasing cancer screening rates. Two predominant determinants of cancer screening success at the clinic level were use of the electronic health record (EHR) and fully engaging nurses in the screening process.ConclusionsJoining an ACO can be a positive driver for increasing cancer screening practices in rural primary care practices. Characteristics of the practice can impact the success of ACO-related cancer screening efforts; engaging nurses to the fullest extent of their education and training and integrating cancer screening into the EHR can optimise the cancer screening workflow.

scholarly journals An embedded multiple case study: using CFIR to map clinical food security screening constructs for the development of primary care practice guidelines

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sabira Taher ◽  
Naoko Muramatsu ◽  
Angela Odoms-Young ◽  
Nadine Peacock ◽  
C. Fagen Michael ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Multiple Case Study ◽  
Food Assistance ◽  
Screening Tools ◽  
Care Practice ◽  
Implementation Barriers ◽  
Implementation Climate ◽  
Multiple Case

Abstract Background Food insecurity (FI), the limited access to healthy food to live an active and healthy life, is a social determinant of health linked to poor dietary health and difficulty with disease management in the United States (U.S.). Healthcare experts support the adoption of validated screening tools within primary care practice to identify and connect FI patients to healthy and affordable food resources. Yet, a lack of standard practices limits uptake. The purpose of this study was to understand program processes and outcomes of primary care focused FI screening initiatives that may guide wide-scale program implementation. Methods This was an embedded multiple case study of two primary care-focused initiatives implemented in two diverse health systems in Chicago and Suburban Cook County that routinely screened patients for FI and referred them to onsite food assistance programs. The Consolidated Framework for Implementation Research and an iterative process were used to collect/analyze qualitative data through semi-structured interviews with N = 19 healthcare staff. Intended program activities, outcomes, actors, implementation barriers/facilitators and overarching implementation themes were identified as a part of a cross-case analysis. Results Programs outcomes included: the number of patients screened, identified as FI and that participated in the onsite food assistance program. Study participants reported limited internal resources as implementation barriers for program activities. The implementation climate that leveraged the strength of community collaborations and aligned internal, implementation climate were critical facilitators that contributed to the flexibility of program activities that were tailored to fill gaps in resources and meet patient and clinician needs. Conclusion Highly adaptable programs and the healthcare context enhanced implementation feasibility across settings. These characteristics can support program uptake in other settings, but should be used with caution to preserve program fidelity. A foundational model for the development and testing of standard clinical practice was the product of this study.

scholarly journals Longitudinal multiple case study on effectiveness of network-based dementia care towards more integration, quality of care, and collaboration in primary care

2018 ◽  
Vol 18 (s2) ◽  
pp. 60
Author(s):  
Anke Richters ◽  
Minke Nieuwboer ◽  
Marcel Olde Rikkert ◽  
Rene Melis ◽  
Marieke Perry ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Multiple Case Study ◽  
Dementia Care ◽  
Multiple Case

scholarly journals Towards community-based integrated care: A qualitative multiple case-study of Dutch primary care centres

2014 ◽  
Vol 14 (6) ◽  
Author(s):  
Karen Schelleman-Offermans ◽  
Maike Tietschert ◽  
Maria Jansen ◽  
Mieke Derickx ◽  
Mieke Steenbakkers ◽  
...  
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Multiple Case Study ◽  
Community Based ◽  
Multiple Case ◽  
Qualitative Multiple Case Study
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