scholarly journals Continuity of care experienced by patients in a multi-institutional pancreatic care network: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. S. Hopstaken ◽  
D. van Dalen ◽  
B. M. van der Kolk ◽  
E. J. M. van Geenen ◽  
J. J. Hermans ◽  
...  
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Pancreatic Surgery ◽  
Tertiary Hospital ◽  
Tumor Board ◽  
Pancreatic Tumors ◽  
Care Network ◽  
Care Services

Abstract Background Over the past decades, health care services for pancreatic surgery were reorganized. Volume norms were applied with the result that only a limited number of expert centers perform pancreatic surgery. As a result of this centralization of pancreatic surgery, the patient journey of patients with pancreatic tumors has become multi-institutional. To illustrate, patients are referred to a center of expertise for pancreatic surgery whereas other parts of pancreatic care, such as chemotherapy, take place in local hospitals. This fragmentation of health care services could affect continuity of care (COC). The aim of this study was to assess COC perceived by patients in a pancreatic care network and investigate correlations with patient-and care-related characteristics. Methods This is a pilot study in which patients with (pre) malignant pancreatic tumors discussed in a multidisciplinary tumor board in a Dutch tertiary hospital were asked to participate. Patients were asked to fill out the Nijmegen Continuity of Care-questionnaire (NCQ) (5-point Likert scale). Additionally, their patient-and care-related data were retrieved from medical records. Correlations of NCQ score and patient-and care-related characteristics were calculated with Spearman’s correlation coefficient. Results In total, 44 patients were included (92% response rate). Pancreatic cancer was the predominant diagnosis (32%). Forty percent received a repetition of diagnostic investigations in the tertiary hospital. Mean scores for personal continuity were 3.55 ± 0.74 for GP, 3.29 ± 0.91 for the specialist and 3.43 ± 0.65 for collaboration between GPs and specialists. Overall COC was scored with a mean 3.38 ± 0.72. No significant correlations were observed between NCQ score and certain patient-or care-related characteristics. Conclusion Continuity of care perceived by patients with pancreatic tumors was scored as moderate. This outcome supports the need to improve continuity of care within multi-institutional pancreatic care networks.

scholarly journals Chronic disease in childhood and adolescence: continuity of care in the Health Care Network

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Vanessa Medeiros da Nóbrega ◽  
Maria Elizabete de Amorim Silva ◽  
Leiliane Teixeira Bento Fernandes ◽  
Claudia Silveira Viera ◽  
Altamira Pereira da Silva Reichert ◽  
...  
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Childhood And Adolescence ◽  
Structured Interviews ◽  
Care Network ◽  
Care Services ◽  
Network Methods ◽  
Health Care Network

abstract OBJECTIVE To evaluate the continuity of care for children and adolescents with chronic diseases in the health care network. METHODS This qualitative study was conducted between February and October 2013 with 12 families, six health managers, and 14 health professionals from different health care services in a municipality of the state of Paraíba, Brazil, using focal groups, semi-structured interviews, and medical record consultation. The data were analyzed by triangulation and thematic analysis. RESULTS Two categories were created: “health care management” and “(dis)continuity of care.” We found gaps in the system, including poor data recording aimed to facilitate follow-up and guide the planning actions as well as sporadic and discoordinate services with a limited flow of information, which hinders follow-up over time. CONCLUSION Continuity of care in the health care network is limited and creates the need to develop strategies to improve these services.

scholarly journals Older multimorbid patients’ experiences on integration of services: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lilian Keene Boye ◽  
Christian Backer Mogensen ◽  
Tine Mechlenborg ◽  
Frans Boch Waldorff ◽  
Pernille Tanggaard Andersen
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Health Care Systems ◽  
Easy Access ◽  
Ageing Population ◽  
Health Providers ◽  
Care Coordinator ◽  
Care Services ◽  
Care Systems

Abstract Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid. Methods A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines. Inclusion criteria: studies exploring patients’ point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done. Results Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care. Conclusions Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.

scholarly journals The qualitative experience of telehealth access and clinical encounters in Australian health care during COVID-19: Implications for policy

2021 ◽  
Author(s):  
Jennifer White ◽  
Julie Byles ◽  
Tom Walley
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Health Care Services ◽  
Care Delivery ◽  
Tertiary Hospital ◽  
Policy Implications ◽  
Australian Health ◽  
Care Services ◽  
Adaptive Models ◽  
Hunter Region

Abstract BackgroundAdaptive models of health care delivery, such as telehealth consultations, have rapidly been adopted to ensure ongoing delivery of essential health care services during COVID-19. However there remain gaps in our understanding of how clinicians have adapted to telehealth. This study aims to explore the telehealth experiences or specialists, based at tertiary hospital in the Hunter Region, and General Practitioners (GP) including barriers, enables and opportunities. Methods In-depth interviews explored the telehealth experiences of specialists, based at tertiary hospital in the Hunter Region of Australia, and General Practitioners (GP) including barriers, enablers and opportunities. Data were analyzed using an inductive thematic approach with constant comparison.ResultsIndividual interviews were conducted with 10 specialist and 5 GPs. Key themes were identified: (1) Transition to telehealth has been valuable but challenging; (2) Persisting telehealth process barriers need addressing; (3) Establishing when face-to-face consults are essential; (4) Changes in workload pressures and potential for double up; (5) Essential modification of work practices and (6) Exploring what is needed going forwardDiscussionWhile there is a need to rationalise and optimise health access during a pandemic, we suggest that more needs to be done improve telehealth going forward. Our results have important policy implications. Specifically, there is a specific need to effectively train clinicians to competently utilize and be confident using this telehealth and to educate patients on necessary skills and etiquette.

scholarly journals Older multimorbid patients’ experiences on integration of services: A systematic review

2019 ◽  
Author(s):  
Lilian Keene Guldhammer Boye ◽  
Christian Backer Mogensen ◽  
Tine Mechlenborg ◽  
Frans Boch Waldorff ◽  
Pernille Tanggaard Andersen
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Health Care Systems ◽  
Easy Access ◽  
Ageing Population ◽  
Health Providers ◽  
Care Coordinator ◽  
Care Services ◽  
Care Systems

Abstract Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid. Methods A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines. Inclusion criteria: studies exploring patients’ point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done. Results 2030 studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care. Conclusions Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.

scholarly journals Continuity of care in heart failure patients

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
K Olsen ◽  
NF Falun ◽  
HK Keilegavlen
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Health Care ◽  
Continuity Of Care ◽  
Secondary Care ◽  
Health Care Services ◽  
Care Services ◽  
Discharge From Hospital ◽  
Patients Experience

Abstract Funding Acknowledgements Type of funding sources: None. Background  Heart failure (HF) requires follow-up over time and by several different health services. The positive effects of follow-up care in secondary care services is well known. However, there is a lack of knowledge in how HF patients experience continuity of care a through various health care services in secondary and primary care. Purpose To explore how HF patients experience continuity of care through secondary and primary health care services. Methods The study used an inductive design by performing four semi-structured focus group interviews. Overall, 17 patients, mean age of 71 years (range 42-95), 11 men and 6 women, All patients were receiving regular and individual follow-up by cardiac nurses in primary care after hospital discharge The interviews were analysed through qualitative content analysis. Results Gaps in continuity of care were described as challenging. Information about HF at the time of discharge from hospital were not always fully comprehended. Patients experienced physical strain of being lost and abandoned after discharge from hospital. They did not know whom to contact for follow-up.  Appointments with the GP was not agreed or scheduled weeks ahead. Patients appreciated home visit by a cardiac nurse in primary care who provided the patients with knowledge in self-care administration. When experiencing deterioration they could call the cardiac nurse, who could facilitate fast track to the hospital. Self-care was difficult to comprehend, especially for those experiencing comorbidities. Patients also  described the importance of sharing knowledge and experience of living with HF with other patients in a secondary care setting, organized by specialised cardiac nurses. Conclusions There are gaps in continuity in patients’ pathways, throughout both secondary and primary healthcare. Even though patients receive information at discharge from hospital, they felt insecure when returning home. Health care services in the primary care provided the patients with both knowledge and confidence as they regularly met the patients, both at home and in organized primary care meetings.

scholarly journals Continuity of care is associated with satisfaction with local health care services

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Lautamatti ◽  
M. Sumanen ◽  
R. Raivio ◽  
K. J. Mattila
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Local Health ◽  
Care Services ◽  
Local Health Care
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