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1 – 10 of 491Siu Mee Cheng and Cristina Catallo
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address…
Abstract
Purpose
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address the social isolation and health needs of a highly vulnerable older adult population living in the north Toronto communities. These are Russian-speaking Jewish older adult immigrants. The case provides a detailed description of the factors that enabled a diverse group of health and social care organizations to integrate their respective services to address the health and social care needs of their clients using a culturally appropriate and trauma-informed lens.
Design/methodology/approach
A case description comprised of key informant interviews, and a focus group was undertaken of representatives from health and social care organizations serving clients in the north Toronto area.
Findings
This case description identified eleven integration factors that enabled organizations to provide integrated care using a culturally appropriate and trauma-informed lens, and they include developing an aligned vision and goals, communications, an inter-organization culture of inter-dependence, champions, pre-existing relationships, and champions. In addition, operating in the not-for-profit sector, sector differences, enabling public policies and a strong sense of community have influenced integration of services across the organizational partners to serve its high-risk client group.
Originality/value
This case description lends insights into how IHSC can be leveraged to provide culturally appropriate and trauma-informed care for highly vulnerable client/patient populations. A lesson learnt is that social care partners can engage in successful integration leadership in joint health and social care integration efforts.
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Bonnie Poksinska and Malin Wiger
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…
Abstract
Purpose
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.
Design/methodology/approach
The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).
Findings
The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.
Practical implications
The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.
Originality/value
The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.
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Siu Mee Cheng and Cristina Catallo
Rural regions in Canada are aging faster than urban centers, but access to health and social care is limited. Integrated health and social care (IHSC) through collaboration across…
Abstract
Purpose
Rural regions in Canada are aging faster than urban centers, but access to health and social care is limited. Integrated health and social care (IHSC) through collaboration across different health and social care organizations can support enhanced care for older adults living in rural regions. However, IHSC is not well understood within a rural Canadian context.
Design/methodology/approach
A case study of a Canadian IHSC initiative, Geriatric Assessment Program Collaboratory (GAPC), in northern Alberta was undertaken to understand how successful IHSC can occur in an urban/rural region. The study used key informant interviews and a focus group of representatives from the GAPC organizations.
Findings
Nine factors were identified that support GAPC: communications, information sharing, shared vision and goals, inter-organizational culture, diffused leadership, team-based approaches, dedicated resources, role clarity, champions and pre-existing relationships. Eight external influence factors were identified as influencing partnership including geography, strong sense of community, inter-sectoral work, public policy, governance authorities and structures, funding models, aging communities and operating within a not-for-profit (NFP) setting.
Originality/value
The study reveals insights into how IHSC can occur within a rural Canadian context. This study demonstrates that IHSC occurs at the local level and that primary care providers can drive IHSC successfully.
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Anna Hallberg, Ulrika Winblad and Mio Fredriksson
The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to…
Abstract
Purpose
The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to elucidate the challenges of vertical policy coordination between non-political actors at the national and regional levels regarding this policy issue, using Sweden as our case.
Design/methodology/approach
Interviews with key actors at the national and regional levels were analyzed using an adapted version of a conceptualization by Adam et al. (2019), depicting barriers to vertical policy coordination.
Findings
Our results show that the main issues in the Swedish context were related to parallel sovereignty and a vagueness regarding responsibilities and mandates as well as complex governmental structures and that this was exacerbated by the unfamiliarity and uncertainty of the policy issue. We conclude that understanding the interaction between the comprehensiveness and complexity of the policy issue and the institutional context is crucial to achieving effective vertical policy coordination.
Originality/value
Many studies have focused on countries’ overall pandemic responses, but in order to improve the outcome of future pandemics, it is also important to learn from more specific response measures.
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Tuomas Hujala and Harri Laihonen
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform…
Abstract
Purpose
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.
Design/methodology/approach
The article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.
Findings
This study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.
Originality/value
This study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.
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Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and…
Abstract
Purpose
This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.
Design/methodology/approach
This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).
Findings
Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.
Originality/value
This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.
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Farooq Ali and Harri Haapasalo
This article aims to address the confusion related to the meanings of interorganisational cooperation, control, coordination and collaboration in collaborative projects by…
Abstract
Purpose
This article aims to address the confusion related to the meanings of interorganisational cooperation, control, coordination and collaboration in collaborative projects by developing a conceptual framework. From this, the authors aim to describe the links among these concepts in terms of development levels of stakeholder relationships. In addition, the authors aim to identify challenges and preconditions in relation to developing relationships at different levels.
Design/methodology/approach
The authors have adopted the directed approach of qualitative content analysis method to validate and extend the conceptual framework of this study. The context of this study is a large hospital construction project located in northern Finland.
Findings
The findings of this study suggest that collaboration is a multilevel process of active engagement of multiple stakeholders. These stakeholders must have a high degree of shared understanding in terms of cooperation, control and coordination to achieve the mutually desired outcomes. This study also identifies the challenges that project stakeholders could face in developing collaborative relationships and propose preconditions for the same.
Practical implications
This study provides a better understanding for project managers to manage interorganisational collaborative construction projects successfully. The outcome of this research would be beneficial to project management team to deliver dispute-free construction projects.
Originality/value
Existing practical research on the development of relationships at different levels in collaborative construction projects is limited. This study offers a framework for the same which is validated in a real-life project.
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Imoh Antai and Roland Hellberg
The total defence (TD) concept constitutes a joint endeavour between the military forces and civil defence structures within a TD state. Logistics is essential for such joint…
Abstract
Purpose
The total defence (TD) concept constitutes a joint endeavour between the military forces and civil defence structures within a TD state. Logistics is essential for such joint collaboration to work; however, the mismatch between military and civil defence logistics structures poses challenges for such joint collaboration. The purpose of this paper is to identify logistics concept areas within the TD framework that allow for military and civil defence collaborations from a logistics operations perspective.
Design/methodology/approach
Pattern-matching analysis is used to compare patterns found in the investigated case with those prescribed from the literature and predicted to occur. The study seeks to identify logistics concepts within TD from the literature and from the events describing the Swedish response to the Covid-19 pandemic. Pattern matching thus allows for the reconciliation of logistics concepts from the literature to descriptions of how the response was handled, albeit under a TD framework.
Findings
Findings show quite distinct foci between the theoretical and observational realms in terms of logistics applications. While the theoretical realm identifies four main logistics concepts, the observational realm identifies five logistics conceptual themes. This goes on to show an incongruence between the military and civil parts of the TD.
Research limitations/implications
This study provides basis for further research into the applications and management of logistics activity within TD and emergency response.
Originality/value
Logistics applications within TD have not, until now, received much attention in the literature. Given this knowledge gap, this study is of original value.
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