Search results

In many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of disease. The interface between primary and secondary care has been identified as a problem area. This paper aims to undertake a scoping review to gain a deeper understanding of the markers of integration across the primary–secondary interface.

A search was conducted of PubMed, SCOPUS, Cochrane Library and the grey literature for papers published in English using the framework described by Arksey and O'Malley. The search process was guided by the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA).

The initial database search identified 112 articles, which were screened by title and abstract. A total of 26 articles were selected for full-text review, after which nine articles were excluded as they were not relevant to the research question or the full text was not available. In total, 17 studies were included in the review. A range of study designs were identified including a systematic review (n = 3), mixed methods study (n = 5), qualitative (n = 6) and quantitative (n = 3). The included studies documented integration across the primary–secondary interface; integration measurement and factors affecting care coordination.

Many studies examine individual aspects of integration. However, this study is unique as it provides a comprehensive overview of the many perspectives and methodological approaches involved with evaluating integration within the primary–secondary care interface and primary care itself. Further research is required to establish valid reliable tools for measurement and implementation.

The purpose of this paper is to examine workarounds from the perspective of the users of the system, focusing on the outcomes of workarounds and their effect on the quality of accounting information.

Interviews were conducted with employees in the accounting functions at two international organizations using SAP for their enterprise system. Results were coded by two experienced researchers and one undergraduate student, and included a categorization of the outcomes of workarounds.

The most striking result is the difference in views of workarounds between the two organizations. While workarounds are discouraged by the accounting function at both organizations, one seeks out workarounds and enforces standards while the other has not yet achieved process standardization. Not surprisingly, users view the workarounds of others as very detrimental to the quality of accounting information, but view their own workarounds as critical to maintain quality.

Organizations should obtain input from system users to document the extent that workarounds are used within the organization to determine the impact on the quality of their financial reporting.

The focus on outcomes of workarounds is an important shift in the literature, and more work is needed to further refine the categories used in this research, particularly for the effect of workarounds on internal controls and information quality. Additionally, this research surfaced a very strong difference in the actions taken to deal with workarounds, which may be due to organizational cultures.