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Article
Publication date: 18 June 2021

Teresa Burdett and Joanne Inman

Due to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena.

1083

Abstract

Purpose

Due to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena.

Design/methodology/approach

A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Papers included in this review focused upon person-centred integrated care and a health promotion/public health approach (January 2018–October 2020). Papers were excluded due to not being written in English, not fitting the age criteria and not being peer reviewed.

Findings

Eight studies met the inclusion criteria and three overarching themes were identified with regards to person-centred integrated care as a health promotion/public health approach: Core components; Development, implementation, and evaluation of models of care and relationship to population health and wellbeing outcomes.

Research limitations/implications

The need for person-centred integrated care as a health promotion/public health approach, to enhance population health and well-being outcomes requires further research to continue to develop, implement and evaluate models of care.

Originality/value

The international scope of this contemporary review brought together the three concepts of person-centred integrated care and public health, exploring the translation of policy into practice (WHO, 2016). The juxtaposition of public health approaches in the background/consequential or foreground/active agent demonstrates how promotion, prevention and population health can be re-valued in integrated people-centred health services (WHO, 2016).

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 7 April 2021

Louise Kermode

Person-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how…

Abstract

Purpose

Person-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry.

Design/methodology/approach

This case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care.

Findings

A focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration.

Originality/value

This case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 29 April 2021

Kathy Kornas, Meghan O'Neill, Catherine Y. Liang, Lori Diemert, Tsoleen Ayanian, Melissa Chang and Laura Rosella

The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical…

Abstract

Purpose

The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.

Design/methodology/approach

The authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.

Findings

The IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.

Originality/value

This study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 July 2020

Giovanna I. Cruz and Sarah M. McGhee

This case study aims to understand the experience of care from a patient/carer perspective and to describe how the method can be replicated to address gaps in evidence relating to…

Abstract

Purpose

This case study aims to understand the experience of care from a patient/carer perspective and to describe how the method can be replicated to address gaps in evidence relating to integrated person-centred care.

Design/methodology/approach

The case study was constructed using data extracted from personal diaries and medical records kept by a person with a complex condition, correspondence with family from the last 18 months of life and interviews with the carer and long-term conditions coordinator. The number of professionals or teams involved in providing care from statutory services, the third sector, and private providers were counted to understand the ecosystem of care. The number of contacts was plotted by provider and purpose of care. The type of care and hours of respite were estimated. A protocol was developed to assess the feasibility of replicating the data and analyses used.

Findings

There were 35 care providers from the public, private and the third sector, demonstrating that only the patient or carer can identify the ecosystem of care. The majority of care was for respite and on average, the carer provided four hours of care per every respite care hour. The method was replicated successfully.

Research limitations/implications

The case study formed the basis of a workshop that brought together health care professionals from the public services and the third sector. The discussion led to the identification of gaps and areas where greater coordination between providers would benefit patients.

Originality/value

The case study method combines contemporaneous patient and carer sources of data and health service activity to create a detailed account of care at the end of life. The approach addresses gaps in person-centred evidence for the development and evaluation of integrated palliative and end-of-life care.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 29 April 2021

Daniel Lombard

Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations…

1179

Abstract

Purpose

Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations for a person-centred, joined-up approach. However, the term is used as a composite and its definition lacks shape and focus. In existing literature, participants appear to be selected on the basis of specific illnesses rather than age. Better understanding of the features of everyday communication processes associated with person-centred care can lead to improvements in policy and practice.

Design/methodology/approach

A scoping review examined communication features associated with person-centred care for older adults. This identified the extent and nature of literature. Several databases were searched; after screening and hand-searching, 31 were included. Findings were analysed for patterns and contradictions, against the objectives of person-centred and integrated care.

Findings

Emotional intelligence and the ability to employ various communication styles are crucial skills of person-centred communication. Such approaches can have positive effects on the well-being of older people.

Research limitations/implications

Some studies' validity was weakened by methodological designs being founded on value judgements.

Practical implications

Using personalised greetings alongside verbal and non-verbal prompts to keep residents emotionally connected during personal care is considered good practice. Stimulating feedback from people using services and their relatives is important.

Originality/value

The role of communication is highlighted in many professional guidance documents on person-centred and integrated care, but the process of implementation is decentralised to individual employers and workers. This paper draws on the findings of contemporary literature, grounded in naturalistic data, with implications for practice and policy.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 10 June 2021

Julie MacInnes, Jenny Billings, Alexandra Lelia Dima, Chris Farmer and Giel Nijpels

The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the…

Abstract

Purpose

The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.

Design/methodology/approach

An integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.

Findings

Twelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.

Originality/value

This review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 6 February 2020

Agnieszka Sobolewska, Amy-Louise Byrne, Clare Lynette Harvey, Eileen Willis, Adele Baldwin, Sandy McLellan and David Heard

The purpose of the paper is to explore how the national, state and organisational health policies in Australia support the implementation of person-centred care in managing…

1010

Abstract

Purpose

The purpose of the paper is to explore how the national, state and organisational health policies in Australia support the implementation of person-centred care in managing chronic care conditions.

Design/methodology/approach

A qualitative content analysis was performed regarding the national, state and organisational Queensland Health policies using Elo and Kyngas' (2008) framework.

Findings

Although the person-centred care as an approach is well articulated in health policies, there is still no definitive measure or approach to embedding it into operational services. Complex funding structures and competing priorities of the governments and the health organisations carry the risk that person-centred care as an approach gets lost in translation. Three themes emerged: the patient versus the government; health care delivery versus the political agenda; and health care organisational processes versus the patient.

Research limitations/implications

Given that person-centred care is the recommended approach for responding to chronic health conditions, further empirical research is required to evaluate how programs designed to deliver person-centred care achieve that objective in practice.

Practical implications

This research highlights the complex environment in which the person-centred approach is implemented. Short-term programmes created specifically to focus on person-centred care require the right organisational infrastructure, support and direction. This review demonstrates the need for alignment of policies related to chronic disease management at the broader organisational level.

Originality/value

Given the introduction of the nurse navigator program to take up a person-centred care approach, the review of the recent policies was undertaken to understand how they support this initiative.

Details

Journal of Health Organization and Management, vol. 34 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 18 March 2022

Helen Tucker

This paper presents my experience of breast cancer care in which I describe my care as positive and integrated.

Abstract

Purpose

This paper presents my experience of breast cancer care in which I describe my care as positive and integrated.

Design/methodology/approach

I have applied an autoethnographical approach to my patient story to analyse my care in order to reflect and share insights. I have applied my knowledge and experience in integrated care through my research, management and practice.

Findings

In my patient story I describe being empowered and feeling like “one of the team.” Vertical and horizontal integration was evident across staff services and agencies. This included integrated working across multi‐disciplinary teams, between primary and secondary care and also between the NHS and a voluntary agency. I identified features that were important to me in my care under the headings of: certainty, communication, contact, compassion, continuity, cohesive, care and collaboration.

Practical implications

I consider the implications of sharing patient stories to inform quality improvement, influence education and training for staff and design support for patients. I consider how patients can be more involved in the evaluation of their care.

Originality/value

This viewpoint has been written from my perspective as a patient and a professional, and was written in order to recognise good practice and share the learning for continual quality improvement. There is every sign that person-centred integrated care is starting to be embedded in some of our services and hopefully this will be recognised, celebrated and sustained.

Article
Publication date: 7 December 2018

David Robertshaw and Ainslea Cross

Effective integrated healthcare systems require capable, trained workforces with leadership, shared governance and co-ordination. The purpose of this paper is to characterise…

Abstract

Purpose

Effective integrated healthcare systems require capable, trained workforces with leadership, shared governance and co-ordination. The purpose of this paper is to characterise roles and responsibilities in relation to integrated care from the perspective of massive open online course (MOOC) participants.

Design/methodology/approach

MOOC discussion board posts were analysed using framework analysis consisting of transcription, familiarisation, coding, developing an analytical framework and application of the framework.

Findings

Boundaries and key issues surrounding roles and responsibilities were highlighted and participants suggested a number of enablers which could enhance integrated care in addition to barriers to consider and overcome.

Originality/value

Enablers included introduction of shared communication and IT systems to support continuity of care. Awareness and understanding of dementia was seen as crucial to promote person-centred care and care planning. The roles of education and experience were highlighted. Barriers preventing effective roles and suitable responsibility include funding, role conflicts, time constraints and time-consuming paperwork.

Details

Journal of Integrated Care, vol. 27 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 4 December 2023

Mariona Espaulella-Ferrer, Felix Jorge Morel-Corona, Mireia Zarco-Martinez, Alba Marty-Perez, Raquel Sola-Palacios, Maria Eugenia Campollo-Duquela, Maricelis Cruz-Grullon, Emma Puigoriol-Juvanteny, Marta Otero-Viñas and Joan Espaulella-Panicot

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of…

Abstract

Purpose

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

Design/methodology/approach

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

Findings

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

Originality/value

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

1 – 10 of over 1000