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1 – 2 of 2Thomas Round, Mark Ashworth, Tessa Crilly, Ewan Ferlie and Charles Wolfe
A well-funded, four-year integrated care programme was implemented in south London. The programme attempted to integrate care across primary, acute, community, mental health and…
Abstract
Purpose
A well-funded, four-year integrated care programme was implemented in south London. The programme attempted to integrate care across primary, acute, community, mental health and social care. The purpose of this paper is to reduce hospital admissions and nursing home placements. Programme evaluation aimed to identify what worked well and what did not; lessons learnt; the value of integrated care investment.
Design/methodology/approach
Qualitative data were obtained from documentary analysis, stakeholder interviews, focus groups and observational data from programme meetings. Framework analysis was applied to stakeholder interview and focus group data in order to generate themes.
Findings
The integrated care project had not delivered expected radical reductions in hospital or nursing home utilisation. In response, the scheme was reformulated to focus on feasible service integration. Other benefits emerged, particularly system transformation. Nine themes emerged: shared vision/case for change; interventions; leadership; relationships; organisational structures and governance; citizens and patients; evaluation and monitoring; macro level. Each theme was interpreted in terms of “successes”, “challenges” and “lessons learnt”.
Research limitations/implications
Evaluation was hampered by lack of a clear evaluation strategy from programme inception to conclusion, and of the evidence required to corroborate claims of benefit.
Practical implications
Key lessons learnt included: importance of strong clinical leadership, shared ownership and inbuilt evaluation.
Originality/value
Primary care was a key player in the integrated care programme. Initial resistance delayed implementation and related to concerns about vertical integration and scepticism about unrealistic goals. A focus on clinical care and shared ownership contributed to eventual system transformation.
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Siti Salbiah Zainal Abidin and Mohd Heikal Husin
Document management system is an essential approach that should be managed well to ensure an effective and faster overall working process in an organization. Hardcopy documents…
Abstract
Document management system is an essential approach that should be managed well to ensure an effective and faster overall working process in an organization. Hardcopy documents has been one of the items that most organizations need to manage in a safe and secure manner due to the high dependency on most of their working procedure especially in government organizations. Hence, we proposed a new framework to improve the weaknesses of the existing document management procedures in government organizations. Our proposed framework integrates the implementation of an NFC system in this research due to its secure short - range communication, and the peer-to-peer communication capability in most mobile devices. Besides that, most existing government organizations within Malaysia could easily implement such technology for their internal usage as this technology is cost effective due to its availability on existing mobile devices on most Android based devices.
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