scholarly journals Implementing Integrated Care in Practice – Learning from MDTs Driving the Integrated Care Programme for Older Persons in Ireland

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Barry ◽  
Maebh Ní Fhallúin ◽  
Stephen Thomas ◽  
PJ Harnett ◽  
Sara Burke
Keyword(s):  
Integrated Care ◽  
Older Persons ◽  
Care Programme

Effect of an integrated care programme on re-hospitalization of patients with chronic obstructive pulmonary disease

Respirology ◽  
2012 ◽  
Vol 17 (4) ◽  
pp. 707-714 ◽  
Author(s):  
GRÉGORY MOULLEC ◽  
KIM L. LAVOIE ◽  
KHALIL RABHI ◽  
MARCEL JULIEN ◽  
HÉLÈNE FAVREAU c ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Integrated Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Care Programme ◽  
Obstructive Pulmonary Disease

scholarly journals The Development of an Inclusion Health Integrated Care Programme for Homeless Adults in Dublin, Ireland

2018 ◽  
Vol 18 (s2) ◽  
pp. 184 ◽  
Author(s):  
Clíona Ní Cheallaigh ◽  
Ann-Marie Lawlee ◽  
Jess Sears ◽  
Joanne Dowds
Keyword(s):  
Integrated Care ◽  
Care Programme ◽  
Homeless Adults

scholarly journals An integrated care programme in London: qualitative evaluation

2018 ◽  
Vol 26 (4) ◽  
pp. 296-308 ◽  
Author(s):  
Thomas Round ◽  
Mark Ashworth ◽  
Tessa Crilly ◽  
Ewan Ferlie ◽  
Charles Wolfe
Keyword(s):  
Nursing Home ◽  
Integrated Care ◽  
Hospital Admissions ◽  
Clinical Care ◽  
System Transformation ◽  
Care Programme ◽  
Content Type ◽  
Lessons Learnt ◽  
Health And Social Care ◽  
Shared Ownership

PurposeA 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/approachQualitative 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.FindingsThe 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/implicationsEvaluation 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 implicationsKey lessons learnt included: importance of strong clinical leadership, shared ownership and inbuilt evaluation.Originality/valuePrimary 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.

scholarly journals Impact of integrated care on trends in the rate of emergency department visits among older persons in Stockholm County: an interrupted time series analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036182
Author(s):  
Megan Doheny ◽  
Janne Agerholm ◽  
Nicola Orsini ◽  
Pär Schön ◽  
Bo Burström
Keyword(s):  
Emergency Department ◽  
Time Series ◽  
Time Series Analysis ◽  
Integrated Care ◽  
Older Persons ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Stockholm County ◽  
Series Analysis ◽  
Ed Visits

ObjectiveTo investigate the association between the implementation of an integrated care (IC) system in Norrtälje municipality and changes in trends of the rate of emergency department (ED) visits.DesignInterrupted time series analysis from 2000 to 2015.SettingStockholm County.ParticipantsAll inhabitants 65+ years in Stockholm County on 31 December of each study year.InterventionIC was established by combining the funding, administration and delivery of health and social care for older persons in Norrtälje municipality, within Stockholm County.OutcomeRates of hospital-based ED visits.ResultsIC was associated with a decrease in the rate of ED visits (incidence rate ratio: 0.997, 95% CI 0.995 to 0.998) among inhabitants 65+ years in Norrtälje. However, the rate of ED visits remained higher in Norrtälje than the rest of Stockholm in the preintervention and postintervention periods. Stratified analyses showed that IC was associated with a decline in the trend of the rate of ED visits among those 65–79 years, the lowest income group and born outside of Sweden. However, there was no significant decrease in the trend among those 80+ years.ConclusionThe implementation of IC was associated with a modest change in the trend of ED visits in Norrtälje, though the rate of ED visits remained higher than in the rest of Stockholm. Changes in the composition of the population and contextual changes may have impacted our findings. Further research, using other outcome measures is needed to assess the impact of IC on healthcare utilisation.

Healthcare staff perceptions of integrated care in a programme for complex chronic patients admitted to hospital because of heart failure (ProMIC)

2019 ◽  
Vol 22 (2) ◽  
pp. 81-89 ◽  
Author(s):  
Cristina Domingo ◽  
Iratxe Regidor ◽  
Edurne Alonso ◽  
Ariadna Besga ◽  
Domingo Orozco ◽  
...  
Keyword(s):  
Heart Failure ◽  
Integrated Care ◽  
Large Scale ◽  
Care Needs ◽  
Chronic Patients ◽  
Care Programme ◽  
Patients With Heart Failure ◽  
Care Approach ◽  
Study Participants ◽  
Complex Care Needs

Introduction Patients with heart failure are usually a frail population characterised by complex care needs. To ensure an integrated care approach, it is necessary to work collaboratively across organisational boundaries. The purpose of this study is to measure and understand the perception of collaboration between clinicians participating in a comprehensive care programme for patients with heart failure, known as PROMIC. Methods A sequential mixed-method study design was used. A sample of PROMIC clinicians completed a survey in which they evaluated 10 dimensions of collaboration in 2010 and in 2014. The perspectives of clinicians were studied more in depth in a focus group in 2012, which was analysed using content analysis. Outcomes: Professionals’ perception of collaboration showed an improvement by 1.18 points (53%) over the period 2010–14. The comprehensive programme proved to be of major support to the professionals. Sometimes, the study participants did not feel prepared to manage cases due to the complexity of the situations with regard to patients’ care. Both, the quantitative and the qualitative methods, showed up a congruent information about the positive perception of participants of the programme itself and the collaboration. Discussion The complexity of care processes and the need for continuity of care mean that large-scale collaboration is necessary between care levels as well as major interdisciplinary teamwork, to achieve the best possible outcomes in terms of health. ProMIC intervention has helped to improve professionals’ perception in terms of collaboration between levels.

Assessing the impact of food insecurity on HIV medication adherence in the context of an integrated care programme for people living with HIV in Vancouver, Canada

2019 ◽  
Vol 23 (4) ◽  
pp. 683-690 ◽  
Author(s):  
Katrina Koehn ◽  
Taylor McLinden ◽  
Alexandra B Collins ◽  
Patrick McDougall ◽  
Rosalind Baltzer-Turje ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Integrated Care ◽  
Household Food Security ◽  
People Living With Hiv ◽  
Care Programme ◽  
Health Related ◽  
Living With Hiv ◽  
The Impact ◽  
The Relationship

AbstractObjective:Food insecurity, or self-reports of inadequate food access due to limited financial resources, remains prevalent among people living with HIV (PLHIV). We examined the impact of food insecurity on combination antiretroviral therapy (cART) adherence within an integrated care programme that provides services to PLHIV, including two meals per day.Design:Adjusted OR (aOR) were estimated by generalized estimating equations, quantifying the relationship between food insecurity (exposure) and cART adherence (outcome) with multivariable logistic regression.Setting:We drew on survey data collected between February 2014 and March 2016 from the Dr. Peter Centre Study based in Vancouver, Canada.Participants:The study included 116 PLHIV at baseline, with ninety-nine participants completing a 12-month follow-up interview. The median (quartile 1–quartile 3) age was 46 (39–52) years at baseline and 87 % (n 101) were biologically male at birth.Results:At baseline, 74 % (n 86) of participants were food insecure (≥2 affirmative responses on Health Canada’s Household Food Security Survey Module) and 67 % (n 78) were adherent to cART ≥95 % of the time. In the adjusted regression analysis, food insecurity was associated with suboptimal cART adherence (aOR = 0·47, 95 % CI 0·24, 0·93).Conclusions:While food provision may reduce some health-related harms, there remains a relationship between this prevalent experience and suboptimal cART adherence in this integrated care programme. Future studies that elucidate strategies to mitigate food insecurity and its effects on cART adherence among PLHIV in this setting and in other similar environments are necessary.

scholarly journals Satisfaction in Older Persons and General Practitioners during the Implementation of Integrated Care

PLoS ONE ◽  
2016 ◽  
Vol 11 (10) ◽  
pp. e0164536 ◽  
Author(s):  
Antonius J. Poot ◽  
Monique A. A. Caljouw ◽  
Claudia S. de Waard ◽  
Annet W. Wind ◽  
Jacobijn Gussekloo
Keyword(s):  
Integrated Care ◽  
General Practitioners ◽  
Older Persons
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