Getting our hopes up: How actors perceive network effectiveness and why it matters

Integrated care networks in multidisciplinary rehabilitation therapy services for childhood oncology close to home: lessons learned from an international environmental scan

BACKGROUND

Integrated care networks (ICNs) close to home have the potential to improve continuity and quality of care for children with cancer and their families during and after treatment. Our goal is to develop such a network for multidisciplinary rehabilitation therapy services (RTS) in The Netherlands, but we lacked a good understanding of an ICN and the factors to make it successful.

PURPOSE

The aim of the study was to learn from initiatives in ICN's internationally, how are ICN's developed, how does it promote collaboration and what are facilitators and barriers in its development and use?

METHODS

We performed an environmental scan. First, we performed a systematic literature search (PubMed) focussing on ICNs for childhood oncology. Secondly, we sent a survey regarding development and use of ICNs to international childhood cancer centers. Participating centers were asked to share information about their initiatives in providing care close to home. Data were summarized descriptively and analyzed using content analysis.

RESULTS

The literature search did not reveal any relevant publications. The results from the survey, including15 countries, provided valuable insights in the understanding of a good ICN, its facilitators and barriers, and the potential added value of developing ICNs close to home to provide continuity and quality of care.

CONCLUSIONS

Our study highlights the perceived importance of ICNs for multidisciplinary RTS in pediatric oncology and provides valuable information for the formation of such a network. Information about the needs from the perspectives of children and parents is currently missing and essential to develop successful ICNs.

Quality indicators for collaborative care networks in persistent somatic symptoms and functional disorders: a modified delphi study

BACKGROUND

Care for persistent somatic symptoms and functional disorders (PSS/FD) is often fragmented. Collaborative care networks (CCNs) may improve care quality for PSS/FD. Effectiveness likely depends on their functioning, but we lack a straightforward quality evaluation system. We therefore aimed to develop quality indicators to evaluate CCNs for PSS/FD.

METHOD

Using an online three-round modified Delphi process, an expert panel provided, selected and ranked quality indicators for CCNs in PSS/FD. Recruited experts were diverse healthcare professionals with relevant experience in PSS/FD care in the Netherlands.

RESULTS

The expert panel consisted of 86 professionals representing 15 disciplines, most commonly physiotherapists, psychologists and medical specialists. 58% had more than 10 years experience in PSS/FD care. Round one resulted in 994 quotations, which resulted in 46 unique quality indicators. These were prioritised in round two and ranked in round three by the panel, resulting in a final top ten. The top three indicators were: "shared vision of care for PSS/FD", "pathways tailored to the individual patient", and "sufficiently-experienced caregivers for PSS/FD".

CONCLUSIONS

The identified quality indicators to evaluate CCNs in the field of PSS/FD can be implemented in clinical practice and may be useful in improving services and when assessing effectiveness.