How to design and implement integrated care programmes: Coordinated care models and Primary Health Care PLUS project in Poland

Abstract Aim: The aim of the study was to describe practices that support collaboration in interprofessional primary health care teams, and identify performance indicators perceived to measure the impact of this collaboration from the perspective of interprofessional health providers. Background: Despite the surge of interprofessional primary health care models implemented across Canada, there is little evidence as to whether or not the intended outcomes of primary health care teams have been achieved. Part of the challenge is determining the most appropriate measures that can demonstrate the value of collaborative care. To date, little remains known about performance measurement from the providers contributing to the collaborative care process in interprofessional primary care teams. Having providers from a range of disciplinary backgrounds assist in the development of performance measures can help identify measures most relevant to demonstrate the value of collaborative care on the intended outcomes of interprofessional primary care models. Methods: A qualitative study; part of a larger mixed methods developmental evaluation to examine performance measurement in interprofessional primary health care teams. A stakeholder workshop was conducted at an annual association meeting of interprofessional primary health care teams in the province of Ontario, Canada. Six questions guided the workshop groups and participant responses were documented on worksheets and flip charts. All responses were collected and entered verbatim into a word document. Qualitative analytic strategies were applied to each question. Findings: A total of 283 primary health care providers from 14 health professions working in interprofessional primary health care teams participated. Top three elements of interprofessional collaboration (total n = 628) were communication (n = 146), co-treatment (n = 112) and patient-based conferences (n = 81). Top three performance indicators currently used to demonstrate the value of interprofessional collaboration (total n = 241) were patient experience (n = 71), patient health status (n = 35) and within team referrals (n = 30).

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Characteristics of Indigenous primary health care models of service delivery: a scoping review protocol

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-2015-2474 ◽

2015 ◽

Vol 13 (11) ◽

pp. 43-51 ◽

Cited By ~ 4

Author(s):

Stephen Harfield ◽

Carol Davy ◽

Elaine Kite ◽

Alexa McArthur ◽

Zachary Munn ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Service Delivery ◽

Scoping Review ◽

Primary Health ◽

Health Care Models ◽

Care Models ◽

Review Protocol ◽

Models Of Service Delivery

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Policy Research Challenges in Comparing Care Models for Dual-Eligible Beneficiaries

Policy Politics & Nursing Practice ◽

10.1177/1527154417721909 ◽

2017 ◽

Vol 18 (2) ◽

pp. 72-83 ◽

Cited By ~ 2

Author(s):

Janet H. Van Cleave ◽

Brian L. Egleston ◽

Sarah Brosch ◽

Elizabeth Wirth ◽

Molly Lawson ◽

...

Keyword(s):

Health Care ◽

Integrated Care ◽

Exploratory Study ◽

Coordinated Care ◽

Care Model ◽

Community Based ◽

Research Challenges ◽

Care Models ◽

Dual Eligible ◽

Community Based Services

Providing affordable, high-quality care for the 10 million persons who are dual-eligible beneficiaries of Medicare and Medicaid is an ongoing health-care policy challenge in the United States. However, the workforce and the care provided to dual-eligible beneficiaries are understudied. The purpose of this article is to provide a narrative of the challenges and lessons learned from an exploratory study in the use of clinical and administrative data to compare the workforce of two care models that deliver home- and community-based services to dual-eligible beneficiaries. The research challenges that the study team encountered were as follows: (a) comparing different care models, (b) standardizing data across care models, and (c) comparing patterns of health-care utilization. The methods used to meet these challenges included expert opinion to classify data and summative content analysis to compare and count data. Using descriptive statistics, a summary comparison of the two care models suggested that the coordinated care model workforce provided significantly greater hours of care per recipient than the integrated care model workforce. This likely represented the coordinated care model's focus on providing in-home services for one recipient, whereas the integrated care model focused on providing services in a day center with group activities. The lesson learned from this exploratory study is the need for standardized quality measures across home- and community-based services agencies to determine the workforce that best meets the needs of dual-eligible beneficiaries.

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Unlocking information for coordination of care in Australia: a qualitative study of information continuity in four primary health care models

BMC Family Practice ◽

10.1186/1471-2296-14-34 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 21

Author(s):

Michelle Banfield ◽

Karen Gardner ◽

Ian McRae ◽

James Gillespie ◽

Robert Wells ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Qualitative Study ◽

Coordination Of Care ◽

Primary Health ◽

Health Care Models ◽

Care Models

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Integrated care transitions: emergency to primary health care

Journal of Integrated Care ◽

10.1108/jica-06-2016-0022 ◽

2016 ◽

Vol 24 (4) ◽

pp. 225-232 ◽

Cited By ~ 1

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.

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Integration, Coordination and Multidisciplinary Care: What can These Approaches Offer to Australian Primary Health Care?

Australian Journal of Primary Health ◽

10.1071/py07024 ◽

2007 ◽

Vol 13 (2) ◽

pp. 56 ◽

Cited By ~ 20

Author(s):

J. Tieman ◽

G. Mitchell ◽

T. Shelby-James ◽

D. Currow ◽

B. Fazekas ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health System ◽

Complex Interventions ◽

Multidisciplinary Care ◽

Chronically Ill ◽

Multidisciplinary Teams ◽

Coordinated Care ◽

Care Needs ◽

Primary Health

Australia's population is ageing and the consequential burden of chronic disease increasingly challenges the health system. This has raised interest in, and awareness of, approaches built on multidisciplinary teams and integrated and coordinated care in managing the complex care needs of patient groups such as the chronically ill or frail aged. A systematic investigation of the literature relating to these approaches provided the opportunity to explore the meaning of these terms and their potential application and relevance to the Australian primary health care setting. Five systematic reviews of a sentinel condition and an exemplar approach to coordinated and multidisciplinary care were completed. Common learnings from the individual reviews were identified. The literature suggests that approaches encouraging a coordinated and multidisciplinary plan of care for individual patients and/or particular populations may improve a variety of outcomes. There are many methodological considerations in conducting reviews of complex interventions and in assessing their applicability to the Australian health system.

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Primary health care social work in Aotearoa New Zealand: An exploratory investigation

Aotearoa New Zealand Social Work ◽

10.11157/anzswj-vol29iss2id285 ◽

2017 ◽

Vol 29 (2) ◽

pp. 119-130 ◽

Cited By ~ 1

Author(s):

Stefanie Dobl ◽

Liz Beddoe ◽

Peter Huggard

Keyword(s):

Health Care ◽

Primary Health Care ◽

Social Work ◽

New Zealand ◽

Social Workers ◽

Social Inequalities ◽

Coordinated Care ◽

Aotearoa New Zealand ◽

Primary Health ◽

Key Stakeholders

INTRODUCTION: The social work profession has a long-standing history of contributing to health care in Aotearoa New Zealand. Traditionally, hospitals have been the stronghold for the profession. However, both international and national evidence demonstrates that social workers have also been integrated in primary health care practices (PHCPs). Primary health care (PHC) provides care in the community and is recognised for its potential to achieve health equity across all population groups. This article reports on a small, qualitative research project which explored the perceptions of key stakeholders about social work integration into PHC and the experiences gained by social workers working within PHCPs regarding their contributions to the achievement of national aspirations for PHC.METHODS: Semi-structured, one-to-one interviews with 18 participants representing three groups (social workers, other PHC professionals and key informants) were undertaken in 2012. The interviews took place in various locations in Aotearoa New Zealand. A general inductive approach was used to identify key themes. FINDINGS: Three key themes were identified from the data: these are issues of context, namely social work professional factors, organisational factors in PHC and lastly, wider factors in the health care system. The integrated social workers enhanced the access of populations to coordinated care, increased engagement with communities, and strengthened the workforce, among other things. These unique contributions towards the PHC vision were well recognised by all groups, with participants calling for the establishment of integrated social work positions on a larger scale. CONCLUSION: The study evidences the successful integration of social workers into PHC practices in Aotearoa New Zealand. This viable model should be of special interest for key stakeholders regarding the design of local, holistic, PHC services which serve populations most affected by health and social inequalities. Importantly, “health for all”, as anticipated by the PHC vision needs long-term and real commitment especially by financial decision-makers.

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