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The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery.

A structural model was developed based on a literature review. Circulation of a 31-indicator questionnaire among service receivers in the healthcare system across India generated 279 valid responses. The research model was assessed using a cross-sectional research design, and the data were analyzed by partial least squares-structural equation modeling.

Integrated supply chain performance (ISCP), internal service quality (ISQ) and coordinated care are antecedents of a value-dense environment, which drives patient-centricity. The leagile supply chain strategy strengthens the relationship between ISCP and coordinated care. Employee trust and commitment acts as a moderator between coordinated care and ISQ.

By adopting the perspective of service receivers, this paper highlights the influence of value-density on patient-centricity in healthcare organizations. Future research should include healthcare professionals’ perceptions of value-dense environment creation.

The study provides suggestions to practitioners for designing patient-centric healthcare services by leveraging ISCP, coordinated care and ISQ in the value-creation process. Recognizing the relationships among these constructs can aid the timely formulation of corrective actions and future policies.

This study underscores patient-centric care as a basis for effectively delivering healthcare as a social good.

This paper contributes to the body of knowledge by identifying and empirically validating the relationships between patient-centricity and value co-creation.

This is a report on a recent development of an innovative coordinated care solution named the Care Coordination Centre (CCC), which targets coordinated care arrangements for a populations expected to benefit the most. The purpose of this paper is to identify the patients who might comprise this group, and to assess the best ways to meet their health, community, and social care needs before and after introducing the coordinated care solution across care settings.

This is a summary of the author’s experience in the design and development of a care coordination business model for US providers and UK Clinical Commissioning Groups (CCGs) using coordinated care not only as a cost-cutting tool, but as a mechanism for creating a flexible and responsive patient-centered care. The author makes an assessment of the economic benefits of coordinated care resulting from: the shift to less costly interventions; reduction in readmissions; reduced unplanned admissions; increased time allocation efficiency of healthcare staff; and the overall reduction in per-patient costs.

The health and social care systems in the USA and the UK are facing the biggest challenges in their history. Payers, providers, governments, and communities need to work to build better coordination and integration mechanisms to manage the increasing demand on health and social care in a period of stagnant health and social care budgets. New innovative models of coordinated care have been developed in both countries, at the local economy level, as the health service systems are undergoing crucial transformation from a supply to a demand-based model. In the UK, the Trafford CCG has commissioned a new CCC, responsible for the delivery of high-quality coordinated care. The CCC is designed to function at clinical, service, and community levels across multiple providers to cover, among other tasks, chronic condition patient case management, risk stratification of preventative, elective, and unscheduled care for the whole region.

Insights from the work with Trafford CCG would be of considerable methodological and practical interest to researchers, policy makers, commissioners, healthcare professionals, and innovators.

The purpose of this paper is to identify the antecedents and outcomes of internal service quality (ISQ) in a health-care environment. The relationships among the heterogeneous health-care environment, coordinated care, perceived organisational support (POS), ISQ, internal customer satisfaction and patient-centred care were explored.

Based on a review of the literature, a structural model was developed. A 37-item questionnaire was circulated among service providers in the health-care system, including doctors, nurses and system staff, all over India. The random sampling method was adopted to collect data. A total of 238 valid responses were received. The data were analysed using structural equation modelling.

The results show that the heterogeneous environment, coordinated care and POS act as antecedents of ISQ, which drives internal customer satisfaction and patient centricity in health care.

The paper contributes to the health-care literature by identifying the antecedents and consequences of ISQ and developing a structural relationship among ISQ, the heterogeneous health-care environment, coordinated care, POS, internal customer satisfaction and patient-centred care.

Hospital administrators may use various constructs of POS, ISQ and coordinated care to measure process and employee performance, which may aid the design of appropriate processes and improve employee selection. The constructs of patient centricity and internal customer satisfaction may be used as benchmarking tools to facilitate the formulation of immediate corrective actions and policies for future courses of action.

This paper highlights how patient centricity may be achieved by focussing on ISQ, coordinated care processes and a facilitative internal environment. This understanding may aid the design of processes that in turn deliver health as a social good in an effective manner.

This paper extends past research on ISQ by showing that ISQ affects internal customer satisfaction and, in turn, the quality of service delivery in the system. In the health-care context, heterogeneity in patient needs, coordinated care and organisational support play crucial roles in determining ISQ, which in turn influences the level of patient-centred care.

The purpose of this paper is to describe the development of a narrative to redefine integrated care from the user's perspective, which is being promoted across England.

The content of the narrative for person-centred coordinated care, recently launched in England, is described. The need for the narrative is explained in the context of the failure of previous integrated care programmes to identify and deliver clear benefits to service users. The sources and stages of development of the narrative are described. The author considers its place in national policy, further content development and its potential to help those planning programmes of integration.

A clear consensus on the need to define integrated care from the service user perspective now exists in England, and a narrative now exists to fulfil this purpose which has been developed by service users, patient groups, care professionals and system leaders. It has radical potential to change service delivery but this will be subject to the degree of local adoption.

The paper is the first journal publication describing the narrative for person-centred coordinated care and creates a record of its developmental stages which will be of interest to system leaders, professionals and researchers in England and internationally.

The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic conditions. Care coordination is defined as a process where physicians, nurses and allied professionals work together to clarify responsibilities, care objectives, treatment plans and discharge plans for delivery of unified care. Patient-centricity is defined as an approach of delivering quality care to patients that focuses on creating a positive experience for them.

A literature review was used to identify measures of care coordination and then partial least square structural equation modeling was used to assess interrelationship among patient-centricity, measures of care coordination and delivery of quality care.

Results reveal that care coordinated pathways consist of IT-enabled coordination, interprofessional teamwork, information sharing and facilitative infrastructure requirements and are influenced by patient-centricity. These are deliberate requisites for delivering of quality care. Results of this study present a validated model of care coordination for older people, which may be further explored to refine the concept of care coordination.

Based on these results, practitioners may develop an overarching strategy to deliver seamless care and to achieve better health outcomes. Measures of care coordination may be used as a performance benchmarking tool and will also help in the process mapping of hospitals.

This paper highlights how patient-centricity may be achieved by focusing on coordinated care processes. This understanding may help in designing processes, which in turn deliver health as a social good in an effective manner.

Results of this study present such a validated model for care coordination, which can be used by researchers.

Following the development of a service that consisted of a “single point of contact” to coordinate end-of-life care (EoLC), including EoLC facilitators and an urgent response team, we aimed to explore whether the provision of coordinated EoLC would support patients being cared or dying in their preferred place and avoid unwanted hospital admissions.

Using a realist evaluation approach, the authors examined “what worked for whom, how, in what circumstances and why”. Multiple data were collected, including activity/performance indicators, observations of management meetings, documents, satisfaction survey and 30 interviews with service providers and users.

Advance care planning (ACP) increased through the first three years of the service (from 45% to 83%) and on average 74% of patients achieved preferred place of death. More than 70% of patients avoided an emergency or unplanned hospital admission in their last month of life. The mechanisms and context identified as driving forces of the service included: 7/7 single point of contact; coordinating services across providers; recruiting and developing the workforce; understanding and clarifying new roles; and managing expectations.

This was a service evaluation and the outcomes are related to the specific context and mechanisms. However, findings can be transferable to similar settings.

“Single point of contact” services that offer coordinated EoLC can contribute in supporting people to be cared and die in their preferred place.

This paper provides an evaluation of a novel approach to EoLC and creates a set of hypotheses that could be further tested in similar services in the future.

The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.

A qualitative case study primarily consisting of interviews.

The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.

The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.

To meet the multidimensional needs of patients, health services are increasingly implementing complex programmes of care through partnerships between public, private and voluntary sector organisations. The purpose of this paper is to explore the implementation process of a complex, multi-innovative regional health and social care partnership to coordinate end-of-life care in the South East of England.

The study adopted a pragmatic, pluralist design using primarily qualitative methods including observations, interviews, focus group and document review. Implementation theory provided the research framework.

While progress was made towards greater collaboration in the provision of end-of-life care, regional coordination of care among the 13 partner organisations was not achieved as envisioned. Low engagement stemming from national health system changes delayed decision making and shifted partners’ priorities. Individual stakeholder interest and motivation carried the elements that were successful.

The external political and economic environment hindered the involvement of some of the partners and suggests that a concept of “project resiliency” is particularly important for complex, multi-organisational projects which are implemented over time and by multiple stakeholders from different sectors. Future research should look further at what contributes to project resiliency and whether it might be operationalized so that projects can develop resilient factors for success.

Project resiliency is a new concept that bridges a gap in understanding how time-limited multi-organisational projects function amid a changing environment.

Stroke is a leading cause of death and disability in the USA and worldwide. While stroke care has evolved dramatically, many new acute approaches to therapy focus only on the first 3-12 hours. Significant treatment opportunities beyond the first 12 hours can play a major role in improving outcomes for stroke patients. The purpose of this paper is to highlight the issues that affect stroke care delivery for patients and caregivers and describe an integrated care model that can improve care across the continuum.

This paper details evidence-based research that documents current stroke care and efforts to improve care delivery. Further, an innovative integrated care model is described, and its novel application to stroke care is highlighted.

Stroke patients and caregivers face fragmented and poorly coordinated care systems as they move through specific stroke nodes of care, from acute emergency and in-hospital stay through recovery post-discharge at a care facility or at home, and can be addressed by applying a comprehensive, technology-enabled Integrated Stroke Practice Unit (ISPU) Model of Care.

This paper documents specific issues that impact stroke care and the utilization of integrated care delivery models to address them. Evidence-based research results document difficulties of current care delivery methods for stroke and the impact of that care delivery on patients and caregivers across each node of care. It offers an innovative ISPU model and highlights specific tenets of that model for readers.

The authors aim to present findings from their research on the implementation of Unified Assessment (UA) policy and the work of care coordinators who oversee the delivery of support to older people with complex needs.

A mixed methods approach included staff interviews (n=95) and focus groups (n=3).

The care coordinator role is controversial and the lack of common terminology across health and social care obscures its importance. It is seen as a social care responsibility. Limited ownership amongst healthcare professionals leads to tensions in practice. The challenges of breaking down silo thinking embedded in established professional practices are highlighted as are infrastructural and capacity deficits. Disparities between policy intentions and practice means that UA is failing to meet core objectives relating to the delivery of seamless support.

Further research is needed to develop and evaluate evidence‐informed interventions that test solutions to the problems faced in practice and support the delivery of more effective arrangements.

Practice development may be supported by: guidelines that are more prescriptive and include a formal role definition; joint training to promote shared understanding of key concepts; investment in administrative and IT infrastructures; and more coordinated direction at strategic level.

Over a decade has elapsed since the publication of UA Policy Guidance; however, there is limited published evidence on the effectiveness of UA policy and its translation into practice.