Contents

Contents tagged: coordination of care

June 21, 2016 Europe, Global Publication

Can hospital services work in primary care settings?

In this post, the author analyzes how recent changes in primary care in the National Health Services could face the purpose of moving some services from hospital to primary care settings.

The author bases her discussion on a report published by RAND corporation (“Outpatient Services and Primary Care”) that identifies five main areas to be considered when moving services from hospital to primary care:

  1. Transfer: The substitution of services delivered by specialists for services delivered by primary care clinicians.
  2. Relocation: Shifting the venue of specialist care from hospitals to primary care settings.
  3. Liaison: Joint working between specialists and primary care clinicians to provide care to individual patients.
  4. Professional behaviour change: Changing the way GPs refer patients to specialists.
  5. Patient behaviour change: Helping patients make informed decisions about their care.

There is not a unique way of moving these services; many studies suggest that patients’ satisfaction usually grows when services are ...

May 26, 2016 Europe Publication

Reshaping the workforce to deliver the care patients need

Workforce structure is one of the most difficult things to modulate in health systems. Current transition to new models of care could be a good opportunity to make workforce structure match actual needs of systems and populations. In this report, published by the Nuffield Trust, it is analyzed how organizations could reshape their current workforce and what the benefits would be:

There is a need to evolve from an illness-based system to a patient-centred system.
Workforce should meet future needs by incorporating professionals with a vision aligned with future models of care.
There are opportunities to develop the current workforce at all grades: from redeploying support staff, extending the skills of registered professionals and training advanced practitioners.
There is good evidence that support workers can provide good-quality, patient-focused care as well as reduce the workload of more highly qualified staff. Investment here could provide a cost-effective and rapid solution to ...

May 26, 2016 Europe Publication

Developing care for a changing population: Learning from GP-led organisations

The way a health system is organized may influence the care this system provides. In this Nuffield Trust report some GP-led experiences are described, analyzing what are the internal characteristics and external context that have affected GP-led progress.

The intra-organizational characteristics listed are: (I) strong links between clinical leaders and GP member practices, (II) sophisticated strategic and operational management support, (III) use of multiple forms of peer-led improvement, (IV) organizations are both entrepeneurial and pragmatic, (V) linked data between the organization’s own services and other providers.

In what concerns to external context, the three characteristics listed are: (I) a receptive context for change, (II) capability to transfer some of the commissioner role to providers through capitated budgets, (III) slow pace and short-term nature of decision-making.

The slow pace and short-term nature of decision-making in clinical commissioning groups may drive emerging organisations to focus on service developments outside of their ...

May 25, 2016 Americas Publication

Integrating health care and housing to promote healthy aging.

In recent decades, the influence between health status and social conditions has been broadly studied; one of the conditions that has been strongly linked to health status has been housing.

Population ageing and the increase of chronic conditions are two of the drivers that have made that housing conditions become an important factor influencing health.

Many different proposals have been made regarding home care, most of them trying to take hospital care to patient’s home; in this post, some different aspects are discussed, mainly related to what Medicare could do in order to improve housing conditions and its influence in patient’s health: (I) increasing the emphasis on vulnerable population covered by Medicare’s Publicly Assisted Housing Programme, (II) tackling elderly falls as a main health problem and striving to reach the Health People 2020 goal of a 10 percent reduction in the rate of emergency-department visits due to ...

April 21, 2016 Europe Publication

Ten actions required to improve health, social care and well-being in Wales

Health and social care organizations from Wales joined in the Welsh NHS Confederation’s 2016 Challenge Policy Forum and the published  a document called “Ten actions required to improve health, social care and well-being in Wales", trying to establish their priorities in order to get a better system.

The ten priorities described are: long term vision, ensuring financing, planning workforce, person centred and integrated care, public health perspective, improve preventive measurements, creating a culture of honest and open communication with population, improving mental health support, ensuring equal access to health and social care and improving the use of technology.

April 21, 2016 Americas Publication

Experiencing Integrated Health: Ontarians’ views of health care coordination and communication

Health Quality Ontario (HQO) has published an analysis using data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults in order to identify, from a patient perspective, how well different parts of health system are working together.

The HQO extracted a sample with the population from Ontario; Ontarians reported similar results as top-ranking countries in some indicators related to coordination of care; about 80% of Ontarians said they received help from their regular physicians to coordinate their care with other providers.

The sample from Ontario population made able to identify some key points where Canadian Health System can improve in order to get better communication and coordination of care.

April 21, 2016 Global Publication

Integrated care – taking specialist medical care beyond the hospital walls

The Royal College of Physicians has published in 2016 a document titled “Integrated care -  taking specialist medical care beyond the hospital walls”.

In the first part of this document they are described some of the main topics about integrated care, how it is conceptualize and what it really implies for patients, professionals and for the whole system.

Afterwards, some study cases are shown as examples to go deeper into different dimensions of integrated care such as the need for sustainable models of integrated care, leadership, management and governance or self-management and care.

Finally, the document lists five key areas where physicians should focus in order to improve integrated care: (I) Ensure that the patient’s and carer’s perspective is the organising principle of service delivery across organisations, (II) Support population health and wellbeing outside the hospital walls, while offering specialist care within the hospital and being an advocate for ...

March 18, 2016 Global Publication

Physical and mental health: a new frontier for integrated care.

Traditionally, integrated care has been focused on closing the gaps between social and health care. Nevertheless, integrating mental and physical care should also be seen as a way to develop integrated care. In this report published by the King’s Fund, this topic is addressed, describing the current situation of mental and physical care and identifying ten areas where this kind of integration would be most needed:

 

  1. Incorporating mental health into public health programmes.

  2. Promoting health among people with severe mental illness.

  3. Improving management of medically unexplained symptoms in primary care.

  4. Strengthening primary care for the physical health needs of people with severe mental illnesses.

  5. Supporting the mental health for people with long-term conditions.

  6. Supporting the mental health and wellbeing for carers.

  7. Supporting mental health in acute hospitals.

  8. Addressing physical health in mental health inpatient facilities.

  9. Providing integrated support for perinatal mental health.

  10. Supporting the mental health needs of people ...

March 3, 2016 Europe Publication

The Right Medicine: Improving Care in Care Homes.

The increase of polypharmacy together with the population aging is making care homes a central point to develop health care programmes, specially related to medicines management and integration of different health care proffessionals.

The Royal Pharmaceutical Society has recently published a report addressing the main issues of medicine use in care homes. The needs identified by the authors include developing better communication systems, reducing falls in care homes, decreasing inappropriate use of psychotropic medicines, improving coordinated end of life care and lowering waste of medicines at home.

The report includes some recommendations such as giving pharmacists a major role in care homes medicine management, strengthening coordination between physicians and pharmacists or developing programmes of regular medicines review and staff training in integrated teams with other practitioners.

Feb. 1, 2016 Europe Publication

Evaluation of health care delivery integration: The case of the Russian Federation

This case study explores the current state of affairs within Russia's health system providing care for increasingly complex chronic conditions from the perspective of providers, namely physicians. A survey was developed by a group of experts and later distributed by the Russian center for public opinion research in August 2012. It focused on the interactions between providers at different levels of the health system often working in different organizational models such as primary care offices, polyspecialty clinics as well as hospitals. The survey focused on three areas crucial to integration, namely: teamwork, coordination and continuity of care. The results from the survey showed that the level of integration was low by nearly every measure across the different levels of the health system. The authors note that little emphasis has been placed on this issue since the 60/70's "when quite a lot of regulation was issued on district ...