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De Rosis S. Performance measurement and user-centeredness in the healthcare sector: Opening the black box adapting the framework of Donabedian. Int J Health Plann Manage 2024; 39:1172-1182. [PMID: 37947478 DOI: 10.1002/hpm.3732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 12/12/2022] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
The framework of Donabedian is widely applied to performance assessment at the healthcare system level. Donabedian categorised the care quality measurement around three dimensions, namely structure, process, and outcomes. The first dimension concerns the inputs; the second one, the combinations of factors and inputs; the last one, the effectiveness in terms of patients' health status. Donabedian early included in the last dimension the patient satisfaction. Nevertheless, nowadays, outcomes are generally measured through hard endpoints, such as re-admissions and mortality indicators. Recently, the Patient-Reported Outcome Measures (PROMs) have been included among the outcome measures within the Donabedian framework. How to move the concept of patient-centeredness to a macro level, including the patient point of view in care quality measurement, evaluation, and improvement? This paper integrates the Donabedian structure-process-outcome framework, by incorporating in the proper dimension the patient-indicators, namely the abovementioned PROMs and Patient-Reported Experience Measures (PREMs). While PROMs are clearly measures of outcome, PREMs can be collocated in the process dimension, since they can be useful for mapping processes and care pathways, in a lean perspective, as well as in the outcome dimension, because inherently linked to outcome, and enablers of patient-centeredness.
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Affiliation(s)
- Sabina De Rosis
- Management and Healthcare Laboratory, Institute of Management and Department L'EMbeDS, Sant'Anna School, Pisa, Italy
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2
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Feng TL, Stoessl AJ, Harrison RA. Integrated Care in Neurology: The Current Landscape and Future Directions. Can J Neurol Sci 2024:1-9. [PMID: 38679923 DOI: 10.1017/cjn.2024.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The rising burden of neurological disorders poses significant challenges to healthcare systems worldwide. There has been an increasing momentum to apply integrated approaches to the management of several chronic illnesses in order to address systemic healthcare challenges and improve the quality of care for patients. The aim of this paper is to provide a narrative review of the current landscape of integrated care in neurology. We identified a growing body of research from countries around the world applying a variety of integrated care models to the treatment of common neurological conditions. Based on our findings, we discuss opportunities for further study in this area. Finally, we discuss the future of integrated care in Canada, including unique geographic, historical, and economic considerations, and the role that integrated care may play in addressing challenges we face in our current healthcare system.
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Affiliation(s)
- Tanya L Feng
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
| | - A Jon Stoessl
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
- Pacific Parkinson's Research Centre, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Rebecca A Harrison
- Division of Neurology, The University of British Columbia, Vancouver, BC, Canada
- British Columbia Cancer Agency, Vancouver, BC, Canada
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3
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Reichman M, Briskin EA, Duarte BA, Vranceanu AM, Grunberg VA. Integrating Psychosocial Care into Orthopedic Settings: A Qualitative Study of Provider Perspectives. Int J Integr Care 2023; 23:15. [PMID: 38074513 PMCID: PMC10705025 DOI: 10.5334/ijic.7579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 10/12/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction Approximately 50% of persons with orthopedic injuries experience psychosocial distress (e.g., depression, anxiety), which can predict chronic pain and disability. Offering psychosocial services in orthopedic settings can promote patient recovery. This study explores health care professionals' perceptions of and recommendations regarding integrated psychosocial care for orthopedic settings. Methods We conducted 18 semi-structured focus groups with 79 orthopedic health care professionals (e.g., surgeons, residents, nurses) across three Level I Trauma Centers. This secondary data analysis used the evidence-based Rainbow Model of Integrated Care framework to structure hybrid inductive-deductive qualitative data analysis. Results Orthopedic health care professionals identified potential benefits to psychosocial service integration across all dimensions of integration (i.e., clinical, professional, organizational, system, functional, and normative). These benefits included increased patient satisfaction with care, decreased burden on medical providers to manage patient distress, and decreased healthcare utilization costs. They also identified barriers (e.g., fast-paced clinic flow, mental health stigma) and offered recommendations to address barriers across dimensions of integration. Conclusion Integrated psychosocial care for orthopedic trauma patients has the potential to improve patient recovery and long-term physical and mental health outcomes. This work identifies strategies to inform the development and implementation of initiatives to integrate psychosocial services within orthopedic settings.
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Affiliation(s)
- Mira Reichman
- University of Washington, Department of Psychology, Seattle, WA, USA
| | - Ellie A. Briskin
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brooke A. Duarte
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Suffolk University, Department of Psychology, Boston, Massachusetts, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Victoria A. Grunberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Newborn Medicine, MassGeneral for Children, Boston, Massachusetts, USA
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4
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Neill R, Zia N, Ashraf L, Khan Z, Pryor W, Bachani AM. Integration measurement and its applications in low- and middle-income country health systems: a scoping review. BMC Public Health 2023; 23:1876. [PMID: 37770887 PMCID: PMC10537146 DOI: 10.1186/s12889-023-16724-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Despite growing interest in and commitment to integration, or integrated care, the concept is ill-defined and the resulting evidence base fragmented, particularly in low- and middle-income countries (LMICs). Underlying this challenge is a lack of coherent approaches to measure the extent of integration and how this influences desired outcomes. The aim of this scoping review is to identify measurement approaches for integration in LMICs and map them for future use. METHODS Arksey and O'Malley's framework for scoping reviews was followed. We conducted a systematic search of peer-reviewed literature measuring integration in LMICs across three databases and screened identified papers by predetermined inclusion and exclusion criteria. A modified version of the Rainbow Model for Integrated Care guided charting and analysis of the data. RESULTS We included 99 studies. Studies were concentrated in the Africa region and most frequently focused on the integration of HIV care with other services. A range of definitions and methods were identified, with no single approach for the measurement of integration dominating the literature. Measurement of clinical integration was the most common, with indicators focused on measuring receipt of two or more services provided at a single point of time. Organizational and professional integration indicators were focused on inter- and intra-organizational communication, collaboration, coordination, and continuity of care, while functional integration measured common information systems or patient records. Gaps were identified in measuring systems and normative integration. Few tools were validated or publicly available for future use. CONCLUSION We identified a wide range of recent approaches used to measure integration in LMICs. Our findings underscore continued challenges with lack of conceptual cohesion and fragmentation which limits how integration is understood in practice.
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Affiliation(s)
- Rachel Neill
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins International Injury Research Unit, Health Systems Program, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA.
| | - Nukhba Zia
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins International Injury Research Unit, Health Systems Program, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA
| | - Lamisa Ashraf
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins International Injury Research Unit, Health Systems Program, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA
| | - Zainab Khan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins International Injury Research Unit, Health Systems Program, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA
| | - Wesley Pryor
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010, Australia
| | - Abdulgafoor M Bachani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins International Injury Research Unit, Health Systems Program, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA
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5
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Valentijn PP, Eggers C, Bloem BR, Grimes D, Goldman J, McGinley J, Gardner J, Piemonte MEP, Dahodwala N, Brennan L, Iansek R, Kovacs N, Parashos S, Hilel A, Rajan R. Validation of the Rainbow Model of Integrated Care Measurement Tool in Parkinson's Disease. Mov Disord 2023. [PMID: 37148424 DOI: 10.1002/mds.29413] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/11/2023] [Accepted: 04/04/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Integrated care is essential for improving the management and health outcomes for people with Parkinson's disease (PD); reliable and objective measures of care integration are few. OBJECTIVE The aim of this study was to test the psychometric properties of the Rainbow Model of Integrated Care Measurement Tool (RMIC-MT, provider version) for healthcare professionals involved in PD care. METHODS A cross-sectional survey was administered online to an international network representing 95 neurology centers across 41 countries and 588 healthcare providers. Exploratory factor analysis with principal axis extraction method was used to assess construct validity. Confirmatory factor analysis was used to evaluate model fit of the RMIC-MT provider version. Cronbach's alpha was used to assess the internal consistency reliability. RESULTS Overall, 371 care providers (62% response rate) participated in this study. No item had psychometric sensitivity problems. Nine factors (professional coordination, cultural competence, triple aims outcome, system coordination, clinical coordination, technical competence, community-centeredness, person-centeredness, and organizational coordination) with 42 items were determined by exploratory factor analysis. Cronbach's alpha ranged from 0.76 (clinical coordination) to 0.94 (system coordination) and showed significant correlation among all items in the scale (>0.4), indicating good internal consistency reliability. The confirmatory factor analysis model passed most goodness-of-fit tests, thereby confirming the factor structure of nine categories with a total of 40 items. CONCLUSIONS The results provide evidence for the construct validity and other psychometric properties of the provider version of the RMIC-MT to measure integrated care in PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Pim P Valentijn
- Department of Health Services Research, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, the Netherlands
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Center for Mind, Brain and Behavior, Universities Marburg and Giessen, Marburg, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Bastiaan R Bloem
- Scientific Center for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - David Grimes
- Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Jennifer Goldman
- Parkinson's and Movement Disorders Shirley Ryan Ability Lab and Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jennifer McGinley
- Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
| | - Joan Gardner
- Struthers Parkinson's Center, HealthPartners, Minneapolis, Minnesota, USA
| | | | - Nabila Dahodwala
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura Brennan
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, Comprehensive Parkinson Care Program, Parkinson Foundation Centre of Excellence, Kington Centre Monash Health Cheltenham, Cheltenham, Australia
| | - Norbert Kovacs
- Department of Neurology, Medical School, University of Pecs, Pecs, Hungary
- ELKH-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
| | - Sotirios Parashos
- Struthers Parkinson's Center, HealthPartners, Minneapolis, Minnesota, USA
| | - Ariela Hilel
- Movement Disorders Center Unit, Neurology Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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6
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Navarta-Sánchez MV, Palmar-Santos A, Pedraz-Marcos A, Reidy C, Soilemezi D, Haahr A, Sørensen D, Smidt HR, Bragstad LK, Hjelle EG, Haavaag SB, Portillo MC. Perspectives of people with Parkinson's disease and family carers about disease management in community settings: A cross-country qualitative study. J Clin Nurs 2023. [PMID: 36732059 DOI: 10.1111/jocn.16636] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 02/04/2023]
Abstract
AIM To explore perceptions of people with Parkinson's disease and family carers about the use and impact of health and social care services, community and voluntary sector resources for the management of Parkinson's disease. BACKGROUND Resources from outside the formal health care system and collaborations between different levels and sectors could address the unmet needs of people with Parkinson's disease and their family carers and improve the management of Parkinson's disease in the community setting. DESIGN A qualitative exploratory study was carried out in Denmark, Norway, Spain and the United Kingdom and was reported using the COREQ. METHODS Individual semi-structured interviews were conducted with people with Parkinson's disease and family carers between May and August 2020. Interviews were digitally recorded, transcribed verbatim and analysed using thematic analysis. A meta-ethnographic approach was used to analyse and synthesise cross-national findings. RESULTS Forty-seven people with Parkinson's disease and 39 family carers participated in the four countries. Four themes and eight sub-themes emerged: (1) Personalised care for needs throughout the Parkinson's disease journey; (2) Accessibility of different types of support systems (including initiatives to support emotional well-being, physical rehabilitation, information on the healthcare services, voluntary associations and community groups); (3) Multiagency collaborations, a more comprehensive approach; (4) Acknowledgment of people with Parkinson's and family carers own role in Parkinson's disease management. CONCLUSIONS An integrated and person-and-community-centred approach, which includes the participation of the health, social, voluntary and community sectors, is desired by people with Parkinson's disease and their family carers to improve the management of Parkinson's in the community setting. These findings could contribute to the creation of more sustainable care systems at the European level that would better respond to individual and changing needs in people with Parkinson's disease and their family carers, and in other long-term conditions. PATIENT OR PUBLIC CONTRIBUTION The Patient and Public Involvement groups contributed to the design of the study, the interview guides and validation of findings. RELEVANCE TO CLINICAL PRACTICE This study will inform the management of Parkinson's disease at the community level and the use of resources not only directly linked to the health system. Taking into account all the actors that provide care and support to people with Parkinson' disease and family carers facilitates the creation of strategies that better respond to individual needs. Nurses and other health and social care professionals in the community and specialist levels of care should collaborate to develop multisectoral strategies that promote personalised and integrated care throughout the Parkinson's journey.
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Affiliation(s)
| | - Ana Palmar-Santos
- Nursing Department, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Claire Reidy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Dia Soilemezi
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Anita Haahr
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark.,Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dorthe Sørensen
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark
| | - Helle Rønn Smidt
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark
| | - Line Kildal Bragstad
- Department of Public Health Sciences and CHARM - Research Center for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway.,Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Ellen Gabrielsen Hjelle
- Department of Public Health Sciences and CHARM - Research Center for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway.,Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | | | - Mari Carmen Portillo
- NIHR Applied Research Collaboration Wessex, University of Southampton, School of Health Sciences, Southampton, UK
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7
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Hayes C, Manning M, Condon B, Griffin AC, FitzGerald C, Shanahan E, O'Connor M, Glynn L, Robinson K, Galvin R. Effectiveness of community-based multidisciplinary integrated care for older people: a protocol for a systematic review. BMJ Open 2022; 12:e063454. [PMID: 36410816 PMCID: PMC9680188 DOI: 10.1136/bmjopen-2022-063454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The increasing number of older adults with multiple complex care needs has placed increased pressure on healthcare systems internationally to reorientate healthcare delivery. For many older adults, their first point of contact with the health service is with their general practitioner (GP) and GP participation with integrated care models is the foundation of a population-based approach. A knowledge gap remains in relation to the effectiveness of GP participation in community-based integrated health and social care approaches for older adults. This systematic review aims to examine the effectiveness of multidisciplinary-integrated care for community-dwelling older adults with GP participation. METHODS AND ANALYSIS This systematic review will include randomised controlled trials (RCTs), quasi and cluster RCTs focusing on integrated care interventions for community-dwelling older adults by multidisciplinary teams including health and social care professionals and GPs. The databases PUBMED, EMBASE, CINAHL, Central Register of Controlled Trials in the Cochrane Library and MEDLINE will be searched. The primary outcome measure will be functional status. Secondary outcomes will include: primary healthcare utilisation, secondary healthcare utilisation, participant satisfaction with care, health-related quality of life, nursing home admission and mortality. The methodological quality of the studies will be assessed using the Cochrane Risk of Bias Tool V.2. The elements of care integration will be mapped in the individual studies using the Rainbow Model of Integrated Care taxonomy. A meta-analysis will be completed, depending on the uniformity of the data. Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the certainty of evidence. ETHICS AND DISSEMINATION Formal ethical approval is not required as all data included are anonymous secondary data. Scientific outputs will be presented at relevant conferences and in collaboration with our public and patient involvement stakeholder panel of older adults at the Ageing Research Centre at the University of Limerick. PROSPERO REGISTRATION NUMBER CRD42022309744.
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Affiliation(s)
- Christina Hayes
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Molly Manning
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
- Public and Patient Involvement (PPI) Research Unit, University of Limerick, Limerick, Ireland
| | - Brian Condon
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anne Christina Griffin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Christine FitzGerald
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Elaine Shanahan
- Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Margaret O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- HRB, Primary Care Clinical Trials Network, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Tahsin F, Armas A, Kirakalaprathapan A, Cunningham H, Kadu M, Sritharan J, Steele Gray C. Information and Communication Technologies (ICTs) enabling integrated primary care for complex patients: a protocol for a scoping review. Syst Rev 2022; 11:193. [PMID: 36071450 PMCID: PMC9450266 DOI: 10.1186/s13643-022-02057-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/23/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION An increasing number of individuals are living with multiple chronic conditions, often combined with psychosocial complexities. For these patients with complex conditions, an integrated primary care model that provides care coordination and a team-based approach can help manage their multiple needs. Information and communication technologies (ICTs) are recognized as a critical enabler of integrated primary care. A better understanding of the use of ICTs in an integrated care setting and how ICTs are being leveraged would be beneficial to identify knowledge gaps and could lead to successful implementation for ICT-based interventions. OBJECTIVE This study will systematically scope the literature on the topic of ICT-enabled integrated healthcare delivery models for patients with complex care needs to identify which technologies have been used in integrated primary care settings. METHOD This study protocol outlines a scoping review of the peer-reviewed literature, using Arksey and O'Malley's (enhanced by Levac et al.) scoping review methodology. Peer-reviewed literature will be identified using a multi-database search strategy. The results of the search will be screened, abstracted, and charted in duplicate by six research team members. DISCUSSION The key findings of the study will be thematically analyzed to describe the implemented ICTs aimed for complex patients within the integrated primary care model. The finding will highlight what types of ICTs are being put in place to support these models, and how these ICTs are enabling care integration. This review will be the first step to formally identify how ICT is used to support integrated primary health care models. The results will be disseminated through peer-reviewed publications, conference presentations, and special interest groups.
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Affiliation(s)
- Farah Tahsin
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
| | - Alana Armas
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.,Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | | | - Heather Cunningham
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Mudathira Kadu
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Jasvinei Sritharan
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Carolyn Steele Gray
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.,Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
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9
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Development of an evidence-based reference framework for care coordination with a focus on the micro level of integrated care: A mixed method design study combining scoping review of reviews and nominal group technique. Health Policy 2022; 126:245-261. [DOI: 10.1016/j.healthpol.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
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10
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Chang B, Yang Y, Buitrago Leon GA, Lu Y. Effect of Collaborative Governance on Medical and Nursing Service Combination: An Evaluation Based on Delphi and Entropy Method. Healthcare (Basel) 2021; 9:healthcare9111456. [PMID: 34828502 PMCID: PMC8622114 DOI: 10.3390/healthcare9111456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/04/2022] Open
Abstract
[Background]: Improvement of synergies in medical and nursing services can help governments to optimize the allocation of medical resources; however, an appropriate evaluation method is critical for a suitable decision process in this regard. [Method]: To assess the medical and nursing service combination (MNSC) at a regional level, this study applied a five-dimension evaluation index composed of 28 basic response areas related to the MNSC development status in China, determining its respective weight through the Delphi and entropy methods. [Result]: This empirical exercise analyzed the MNSC supply system by interviewing nine heads of medical and nursing institutions and eleven healthcare-related government personnel during August of 2020 in Xinxiang City, Henan province, P.R China. Results showed: (1) public satisfaction with the fees charged by Medical and Nursing service Institutions (MNSI); (2) Medicare and supply services’ policy publicity; (3) the external financing situation of MNSI; (4) the medical staff’s professional quality; (5) the medical facilities and supply of MNSI; and (6) that the recognition level of the development plan of MNSI scored the highest effect on the synergy of MNSC supply among the assessed factors. [Conclusion]: These results showed that an evaluation based on the Delphi and entropy methods can effectively integrate the opinions of experts and related institutions to evaluate synergies on the medical and nursing service supply.
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Affiliation(s)
- Beiquan Chang
- School of Public Policy and Management, Tsinghua University, Beijing 100084, China
- Correspondence: (B.C.); (Y.Y.)
| | - Yansui Yang
- School of Public Policy and Management, Tsinghua University, Beijing 100084, China
- Correspondence: (B.C.); (Y.Y.)
| | | | - Yuzhong Lu
- Glorious Sun School of Business, Donghua University, Shanghai 200051, China;
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11
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Palladino J, Frum-Vassallo D, Taylor JD, Webb VL. Improving medical residents' utilisation of integrated mental health in primary care. BMJ Open Qual 2021; 10:bmjoq-2021-001388. [PMID: 34429300 PMCID: PMC8386211 DOI: 10.1136/bmjoq-2021-001388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background Integration of mental health services allows for improved prevention and management of chronic conditions within the primary care setting. This quality improvement project aimed to increase adherence to and functioning of an integrated care model within a patient-centred medical home. Specifically, the project focused on improving collaboration between Primary Care Mental Health Integration (PC-MHI) and the medical resident Patient Aligned Care Teams (PACT) at a Veterans Affairs Medical Center in Northport, New York (VAMC Northport). Method The project used increased education, training and relationship building among the medical resident PACTs, and the establishment of regularly occurring integrated team meetings for medical and mental health providers. Education of residents was measured with a self-assessment pre-training and post-training, while utilisation was measured by the percentage of patients currently on a PACT’s panel with at least one PC-MHI encounter in the last 12 months (known in VAMC Northport as PACT-15 metric). Results Two resident PACTs that received both training and weekly integrated meetings increased their utilisation of integrated mental health services by 3.8% and 4.5%, respectively. PACTs that participated in training only, with no regular meetings, showed an initial improvement in utilisation that declined over time. Conclusions Training alone appeared beneficial but insufficient for increased integration over time. The addition of a regularly occurring integrated weekly meeting may be a critical component of facilitating sustained mental health integration in a primary care medical home model.
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Affiliation(s)
- Jenna Palladino
- Psychiatry and Behavioral Health, Stony Brook University, Commack, New York, USA
| | | | - Joanne D Taylor
- Psychology Service, Northport VA Medical Center, Northport, New York, USA
| | - Victoria L Webb
- Main Line Therapy and Psychological Services, LLC, Wayne, Pennsylvania, USA
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Clark M, Cornes M, Whiteford M, Aldridge R, Biswell E, Byng R, Foster G, Fuller JS, Hayward A, Hewett N, Kilminster A, Manthorpe J, Neale J, Tinelli M. Homelessness and integrated care: an application of integrated care knowledge to understanding services for wicked issues. JOURNAL OF INTEGRATED CARE 2021. [DOI: 10.1108/jica-03-2021-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PurposePeople experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse) as well as social, financial and housing needs. Addressing these issues requires a high degree of coordination amongst services. It is, thus, an example of a wicked policy issue. The purpose of this paper is to examine the challenge of integrating care in this context using evidence from an evaluation of English hospital discharge services for people experiencing homelessness.Design/methodology/approachThe paper undertakes secondary analysis of qualitative data from a mixed methods evaluation of hospital discharge schemes and uses an established framework for understanding integrated care, the Rainbow Model of Integrated Care (RMIC), to help examine the complexities of integration in this area.FindingsSupporting people experiencing homelessness to have a good discharge from hospital was confirmed as a wicked policy issue. The RMIC provided a strong framework for exploring the concept of integration, demonstrating how intertwined the elements of the framework are and, hence, that solutions need to be holistically organised across the RMIC. Limitations to integration were also highlighted, such as shortages of suitable accommodation and the impacts of policies in aligned areas of the welfare state.Research limitations/implicationsThe data for this secondary analysis were not specifically focussed on integration which meant the themes in the RMIC could not be explored directly nor in as much depth. However, important issues raised in the data directly related to integration of support, and the RMIC emerged as a helpful organising framework for understanding integration in this wicked policy context.Practical implicationsIntegration is happening in services directly concerned with the discharge from hospital of people experiencing homelessness. Key challenges to this integration are reported in terms of the RMIC, which would be a helpful framework for planning better integrated care for this area of practice.Social implicationsAddressing homelessness not only requires careful planning of integration of services at specific pathway points, such as hospital discharge, but also integration across wider systems. A complex set of challenges are discussed to help with planning the better integration desired, and the RMIC was seen as a helpful framework for thinking about key issues and their interactions.Originality/valueThis paper examines an application of integrated care knowledge to a key complex, or wicked policy issue.
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Assessing the Delivery of Coordinated Care to Patients with Advanced Chronic Kidney Disease in Ontario, Canada: A Survey of Patients and Healthcare Professionals. Int J Integr Care 2021; 21:30. [PMID: 34220394 PMCID: PMC8231462 DOI: 10.5334/ijic.5587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: Patients with advanced Chronic Kidney Disease (CKD) have complex health needs, and thus require care that is coordinated across professionals and organizations. This study aimed to describe the extent of coordinated care delivery for patients with advanced CKD from the perspectives of both patients and healthcare professionals. Methods: The Coordination Scale of the Patient Assessment of Chronic Illness Care (PACIC-26) survey was administered to a random sample of 14,257 patients on maintenance dialysis or receiving care in end-stage kidney disease preparation clinics in Ontario, Canada. A five-item survey was administered to 596 multidisciplinary nephrology professionals. Results: Among the 1,925 patient respondents, 67% reported they had been referred to an allied health professional; 19% had been encouraged to attend programs in the community; and 34% had been told how their visits with other types of doctors helped their treatment (% reporting “always” or “most of the time”). Patient responses were significantly different by treatment modality/setting, but not by gender or geographic location of treatment facility. Among the 276 professional respondents, 37% reported their patients’ care was well-coordinated across settings; 56% reported participating in interdisciplinary care planning discussions; and 53% reported they are aware of appropriate home and community services to support their patients (% reporting “always” or “most of the time”). Conclusion: The results suggest that care for patients with advanced CKD in Ontario is not consistently coordinated. Healthcare professionals may enhance patient perceptions of coordinated care through explicit communication with patients about how the professionals they see and treatments or services they receive influence their overall health and well-being. At a systems level, there is a need to improve professional awareness of and linkages to home- and community-based services.
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A Validation Study of the Rainbow Model of Integrated Care-Measurement Tool for Patients in China. Int J Integr Care 2021; 21:5. [PMID: 33976595 PMCID: PMC8064292 DOI: 10.5334/ijic.5603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. The aim of this paper is to modify the original patient version of the RMIC-MT for the Chinese primary care context and validate its psychometric properties. Methods: The translation and adaptation processes were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 386 patients with diabetes attending one of 20 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method was used to assess the construct validity. Confirmation factor analysis was used to evaluate model fit of the modified version. Cronbach’s alpha was used to ascertain the internal consistency reliability. Results: During the translation and adaptation process, all 24 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Five factors (person-centeredness, clinical integration, professional integration, team-based coordination, organizational integration) with 15 items were determined by exploratory factor analysis, accounting for 53.51% of the total variance. Good internal consistency was achieved with each item correlated the highest on an assigned subscale and Cronbach’s alpha score of 0.890. Moderately positive associations (r≥ 0.4, p<0.01) between the score of the scale and these correlations indicate good construct validity. Conclusions: The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT patient version. Its application in China will promote the development of people-centered integrated primary care. However, future studies with diverse samples crossing regions would be needed to test its psychometric properties for the various Chinese primary care contexts.
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Valentijn PP, Kerkhoven M, Heideman J, Arends R. Cross-sectional study evaluating the association between integrated care and health-related quality of life (HRQOL) in Dutch primary care. BMJ Open 2021; 11:e040781. [PMID: 33811050 PMCID: PMC8023735 DOI: 10.1136/bmjopen-2020-040781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population. DESIGN A cross-sectional survey study. SETTING Primary care practice population. PARTICIPANTS A sample (n=5562) of patients in two general practitioner practices in the Netherlands. PRIMARY OUTCOME MEASURES The Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression. RESULTS Overall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95). CONCLUSION This study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.
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Affiliation(s)
- Pim P Valentijn
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Integrated Care Evaluation, Essenburgh Research & Consultancy, Hierden, The Netherlands
| | | | | | - Rosa Arends
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
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Latina R, Salomone K, D’Angelo D, Coclite D, Castellini G, Gianola S, Fauci A, Napoletano A, Iacorossi L, Iannone P. Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228634. [PMID: 33233824 PMCID: PMC7699889 DOI: 10.3390/ijerph17228634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022]
Abstract
Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study was to describe which tools and domains are able to critically evaluate the quality of clinical/care pathways. An overview of systematic reviews was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using Medline, Embase, Science Citation Index, PsychInfo, CINAHL, and Cochrane Library, from 2015 to 2020, and with snowballing methods. The quality of the reviews was assessed with Assessment the Methodology of Systematic Review (AMSTAR-2) and categorized with The Leuven Clinical Pathway Compass for the definition of the five domains: processes, service, clinical, team, and financial. We found nine reviews. Three achieved a high level of quality with AMSTAR-2. The areas classified according to The Leuven Clinical Pathway Compass were: 9.7% team multidisciplinary involvement, 13.2% clinical (morbidity/mortality), 44.3% process (continuity-clinical integration, transitional), 5.6% financial (length of stay), and 27.0% service (patient-/family-centered care). Overall, none of the 300 instruments retrieved could be considered a gold standard mainly because they did not cover all the critical pathway domains outlined by Leuven and Health Technology Assessment. This overview shows important insights for the definition of a multiprinciple framework of core domains for assessing the quality of pathways. The core domains should consider general critical aspects common to all pathways, but it is necessary to define specific domains for specific diseases, fast pathways, and adapting the tool to the cultural and organizational characteristics of the health system of each country.
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Affiliation(s)
- Roberto Latina
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Katia Salomone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Daniela D’Angelo
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Daniela Coclite
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (G.C.); (S.G.)
| | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (G.C.); (S.G.)
| | - Alice Fauci
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Antonello Napoletano
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
| | - Laura Iacorossi
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
- Correspondence:
| | - Primiano Iannone
- National Center for Clinical Excellence, Healthcare Quality and Safety, Istituto Superiore di Sanità, 00162 Rome, Italy; (R.L.); (K.S.); (D.D.); (D.C.); (A.F.); (A.N.); (P.I.)
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Abstract
Introduction Person-centred integrated care is often at odds with how current health care systems are structured, resulting in slower than expected uptake of the model worldwide. Adopting goal-oriented care, an approach which uses patient priorities, or goals, to drive what kinds of care are appropriate and how care is delivered, may offer a way to improve implementation. Description This case report presents three international cases of community-based primary health care models in Ottawa (Canada), Vermont (USA) and Flanders (Belgium) that adopted goal-oriented care to stimulate clinical, professional, organizational and system integration. The Rainbow Model of Integrated Care is used to demonstrate how goal-oriented care drove integration at all levels. Discussion The three cases demonstrate how goal-oriented care has the potential to catalyse integrated care. Exploration of these cases suggests that goal-oriented care can serve to activate formative and normative integration mechanisms; supporting processes that enable integrated care, while providing a framework for a shared philosophy of care. Lessons learned By establishing a common vision and philosophy to drive shared processes, goal-oriented care can be a powerful tool to enable integrated care delivery. Offering plenty of opportunities for training in goal-oriented care within and across teams is essential to support this shift.
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Huang Y, Zhu P, Chen L, Wang X, Valentijn P. Validation of the care providers version of the Rainbow Model of Integrated Care-measurement tool in Chinese primary care systems. BMC Health Serv Res 2020; 20:727. [PMID: 32770995 PMCID: PMC7414573 DOI: 10.1186/s12913-020-05562-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the RMIC-MT and evaluate its psychometric properties by a pilot study in Chinese primary care systems. Methods The translation and adaptation process were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 1610 community care professionals in all 79 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method and promax rotation was used to assess the construct validity. Cronbach’s alpha was utilized to ascertain the internal consistency reliability. Lastly, confirmation factor analysis was used to evaluate the exploratory factor analysis model fit. Results During the translation and adaptation process, all 48 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Six factors (person- & community-centeredness, care integration, professional integration, organizational integration, cultural competence and technical competence) with 45 items were determined by exploratory factor analysis, accounting for 61.46% of the total variance. A standard Cronbach’s alpha of 0.940 and significant correlation among all items in the scale (> 0.4) showed good internal consistency reliability of the tool. And, the model passed the majority of goodness-to-fit test by confirmation factor analysis. Conclusions The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT provider version. Its application in China will promote the development of people-centered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes.
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Affiliation(s)
- Yixiang Huang
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Paiyi Zhu
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Lijin Chen
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xin Wang
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Pim Valentijn
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Integrated Care Evaluation, Essenburgh, Hierden, The Netherlands
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Rajan R, Brennan L, Bloem BR, Dahodwala N, Gardner J, Goldman JG, Grimes DA, Iansek R, Kovács N, McGinley J, Parashos SA, Piemonte ME, Eggers C. Integrated Care in Parkinson's Disease: A Systematic Review and
Meta‐Analysis. Mov Disord 2020; 35:1509-1531. [DOI: 10.1002/mds.28097] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/06/2020] [Accepted: 04/13/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Roopa Rajan
- All India Institute of Medical Sciences New Delhi India
| | | | - Bastiaan R. Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders Nijmegen The Netherlands
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Joan Gardner
- Struthers Parkinson's Center, Park Nicollet Health Services Golden Valley Minnesota USA
| | - Jennifer G. Goldman
- Parkinson's Disease and Movement Disorders, Shirley Ryan Abilitylab; Department of Physical Medicine & Rehabilitation and Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA
| | - David A. Grimes
- Ottawa Hospital, University of Ottawa Brain and Mind Research Institute Ottawa Ontario Canada
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, Comprehensive Parkinson Care Program, Parkinson Foundation Centre of Excellence, Kington Centre Monash Health Cheltenham Victoria Australia
- Department of Clinical Sciences Monash University Clayton Victoria Australia
| | - Norbert Kovács
- Department of Neurology Universityof Pécs Pécs Hungary
- MTA‐PTE Clinical Neuroscience MR Research Group Pécs Hungary
| | - Jennifer McGinley
- Physiotherapy Department The University of Melbourne Melbourne Australia
| | - Sotirios A. Parashos
- Struthers Parkinson's Center, Park Nicollet Health Services Golden Valley Minnesota USA
| | - Maria E.P. Piemonte
- University of Sao Paulo, Medical School, Physical Therapy, Speech Therapy and Occupational Therapy Department Sao Paulo Brazil
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg; Center for Mind, Brain and Behavior Universities Gießen & Marburg Marburg Germany
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Fares J, Chung KSK, Passey M, Longman J, Valentijn PP. Exploring the psychometric properties of the Rainbow Model of Integrated Care measurement tool for care providers in Australia. BMJ Open 2019; 9:e027920. [PMID: 31857296 PMCID: PMC6937055 DOI: 10.1136/bmjopen-2018-027920] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the reliability and validity of a shortened version of the Rainbow Model of Integrated Care (RMIC) measurement tool (MT). The original version of the measurement tool has been modified (shortened) for the Australian context. DESIGN Validation of the psychometric properties of the RMIC-MT. SETTING Healthcare providers providing services to a geographically defined rural area in New South Wales (NSW), Australia. PARTICIPANTS A sample of 56 healthcare providers providing mental and physical healthcare. MAIN OUTCOME MEASURES The psychometric properties of the tool were tested using principal component analysis for validity and Cronbach's alpha for reliability. RESULTS The tool was shown to have good validity and reliability. The 35 items used in the shortened version of the tool were reduced to 29 items grouped into four dimensions: community-governance orientation, normative integration, functional integration and clinical-professional coordination. CONCLUSIONS The shortened version of the RMIC-MT is a valid and reliable tool that evaluates integrated care from a healthcare provider's perspective in NSW, Australia. In order to assess the tool's appropriateness in an international context, future studies should focus on validating the tool in other healthcare settings.
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Affiliation(s)
- Julian Fares
- Engineering and Information Technologies, Project Management Program, University of Sydney, Sydney, New South Wales, Australia
| | - Kon Shing Kenneth Chung
- Engineering and Information Technologies, Project Management Program, University of Sydney, Sydney, New South Wales, Australia
| | - Megan Passey
- University Centre for Rural Health, University of Sydney, Lismore, New South Wales, Australia
| | - Jo Longman
- University Centre for Rural Health, University of Sydney, Lismore, New South Wales, Australia
| | - Pim P Valentijn
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Integrated Care Evaluation, Essenburgh, Hierden, The Netherlands
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