IPCHS. Integrated People-Centred Health Services

Contents

Contents tagged: patient-centred care

Nov. 5, 2019 Western Pacific Publication

Exploring nurse navigators’ contribution to integrated care: a qualitative study

This paper examines nurse navigation as a model of integrated care operating across primary and secondary healthcare settings. A two-phase qualitative study involving a focus group with seven nurse navigators (NNs) to explore their understandings and perceptions of the role, followed by in-depth interviews with three NNs to examine current practice, was undertaken in Queensland, Australia.

May 22, 2019 Europe Publication

Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews

Involvement of patients, health professionals, and the wider public (‘stakeholders’) is seen to be beneficial to the quality, relevance and impact of research and may enhance the usefulness and uptake of systematic reviews. However, there is a lack of evidence and resources to guide researchers in how to actively involve stakeholders in systematic reviews. In this paper, we report the development of the ACTIVE framework to describe how stakeholders are involved in systematic reviews

April 3, 2019 Europe Publication

Continuity of care and referral rate: challenges for the future of health care

Continuity of care could reduce health care consumption by patients and reduce the number of referrals to specialist care, but it is unknown if there is a difference in referral rates to specific medical specialties. The aim was to determine the relationship between continuity of care and both the referral rate (referrals per patient per year) and the medical specialties for which this relationship was strongest.

March 25, 2019 Americas Publication

Evaluating a Community-Placed and Clinically Integrated Community Health Worker Program

Community health worker (CHW) programs can act as bridges between patients and health care teams, but the complexity and variability of program components and outcomes make them difficult to evaluate. This evaluation used a realist approach to identify underlying mechanisms and contextual factors associated with successful implementation of a community-placed CHW program affiliated with a primary care practice in the Midwest United States. The analysis identified mechanisms by which stakeholders built trust, self-efficacy, and empowerment to improve patient-centered outcomes and experiences.

March 25, 2019 Global Publication

Measuring patient-centred system performance: a scoping review of patient-centred care quality indicators

Patient-centred care (PCC) is one of the six dimensions of healthcare and was formally described by the Institute of Medicine in 2001 as healthcare that respects and responds to the preferences, needs and values of the individual patients throughout all healthcare decisions. PCC is an approach that has become central to policies and programming to improve healthcare efficiencies and address patient safety issues.
In that sense, The shift to the patient-centred care (PCC) model as a healthcare delivery paradigm calls for systematic measurement and evaluation. In an attempt to develop patient-centred quality indicators (PC-QIs), this study aimed to identify quality indicators that can be used to measure PCC

March 19, 2019 Global Publication

The role of patient value and patient-centred care in health systems

Patient-centred care, with its emphasis on patient value, is a widespread health system goal. To examine the progress of the evolution towards more patient-centred health care and draw lesson for the future, the Economist Intelligence Unit conducted a survey and interviews on patient representatives, a cohort in which IAPO was present. However, the findings show that despite some progress, especially in Europe and the US, in practice such care often remains more aspiration than reality.

Oct. 4, 2018 South-East Asia Publication

Patient experience of primary care and advance care planning: a multicentre cross-sectional study in Japan.

Advance care planning (ACP) is a process whereby a patient, in consultation with health care providers, family members, and important others, makes decisions about his or her future health care. ACP process includes discussions regarding goals of care, resuscitation and life support, palliative care options, surrogate decision-making and advance directives (AD). Previous studies have shown positive impact of ACP on end-of-life care, including less aggressive medical care and better quality of life; decreased rates of hospital admission, especially of nursing home residents; and increased rates of hospice admission. So the aim of this study was to investigate the relationship between patient experience of primary care and ACP.

Oct. 4, 2018 South-East Asia Publication

Health professional-patient communication practices in East Asia: An integrative review of an emerging field of research and practice in Hong Kong, South Korea, Japan, Taiwan, and Mainland China.

There is a need to consider local culture in understanding and interpreting medical encounters in East Asia. So the aim of this study was to provide an integrative review of literature on health communication in East Asia and detail culturally-specific influences wicht highlights the need for a specific culturally-appropriate model of health communication in East Asia which may significantly improve relationships between clinicians and patients.

Aug. 28, 2018 Global Publication

Case management for integrated care of frail older people in community settings

Demographic changes and advances in medical care and technology have led to an ageing population. Despite gains in life expectancy, compression of morbidity in later life has not been achieved, meaning that although growing numbers of older people are living longer, they are doing so with one or more long?term conditions. A key driving force for international policy agendas worldwide is to improve the quality, efficiency and safety of health and care services through the delivery of effective integrated care systems. Integrated care can be broadly defined as "an organising principle for care delivery that aims to improve patient care and experience through improved coordination", and such approaches are being increasingly implemented as a key policy in many countries. This review will focus on case management as one service model for delivering integrated care, among others. 

July 23, 2018 Americas Publication

Patient-centred care for multimorbidity: an end in itself?

Multimorbidity, which is defined as living with two or more chronic health problems, is a major and growing problem, especially in societies with ageing populations and substantial socioeconomic disparities. It is associated with reduced quality of life, impaired functional status, poor physical and mental health, and increased mortality

May 9, 2018 Global Publication

Talking leadership: clinicians leading transformational change

Taj Hassan, Consultant in Emergency Medicine at Leeds Teaching Hospitals NHS Trust, and President, Royal College of Emergency Medicine, answers some questions about how clinicians are contributing to transformational change in the NHS

April 25, 2018 Americas Publication

Integrating Community Health Workers Into Medical Homes

Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMSs), few PCMHs in Minnesota have incorporated these health workers into their care teams. They undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team

April 2, 2018 Western Pacific Publication

Achieving Integrated Care for Older People: Shuffling the Deckchairs or Making the System Watertight For the Future?

Integrated care has been recognised as a key initiative to resolve the issues surrounding care for older people living with multi-morbidity. Multiple strategies and policies have been implemented to increase coordination of care globally however, evidence of effectiveness remains mixed. The reasons for this are complex and multifactorial, yet many strategies deal with parts of the problem rather than taking a whole systems view with the older person clearly at the centre. 

March 25, 2018 Africa Publication

The perceived impact of family physicians on the district health system in South Africa: a cross-sectional survey

The 2008 World Health Report "Primary Health Care-Now More Than Ever" defines strong Primary Health Care (PHC) systems as those systems which offer first contact care that is patient-centred with an orientation to the patient´s family and community context, embedded in a service that is comprehensive, integrated, continuos, and community-orientated, and in which patient-care is well co-ordinated. This report warned against oversimplified approaches to PHC in developing countries, which only focus on priority deseases or rely on unsupported health workers who are poorly equipped for the complexity of PHC. The World Health Assembly supports the report´s recommendation that PHC should be offered by a multidisciplinary team that includes a family physician. 

March 22, 2018 Global Publication

Integrated Care Planning for Cancer Patients: A Scoping Review

There has been growing emphasis on the use of integrated care plans to deliver cancer care. However little is known about how integrated care plans for cancer patients are developed including featured core activities, facilitators for uptake and indicators for assessing impact. A scoping review was conducted to explore the components of integrated care plans and contextual factors that influence design and uptake. 

March 7, 2018 Western Pacific Publication

Family Medicine Clinic: a case study of a hospital–family medicine practice redesign to improve chronic disease care in the community in Singapore

Singapore´s health care system is strained by the health care needs of a rapidly aging population. The unprecedented collaboration between a public hospital and a private family practice to set up the Family Medicine Clinic (FMC) to co-manage patients with chronic desease is an example of efforts to shift care to community. 

Feb. 19, 2018 Americas Publication

Health Services Research Spending and Healthcare System Impact

The challenges associated with translating health services and policy research evidence into practice are many and long-standing. Indeed, those challenges have themselves spawned new areas of research, including knowledge translation and implementation science. These sub-disciplines have increase our understanding of the critical success factors associated with the uptake of research evidence into (system) practice. In that regard, building on Canada´s recent Strategy for Patient Oriented Research would seem to offer consideravle promise. The "modest" proposals offered by Thakkar and Sulivan seem less likely to bear fruit. 

Feb. 19, 2018 Western Pacific Publication

The Western Sydney Integrated Care Program (WSICP): Qualitative Evaluation

The ageing population together with an increasing prevalence of chronic conditions require a systems wide integrated approach to health care. This includes overcoming barriers between primary and secondary care, physical and mental health, and health and social care in order to provide patient centred care. In Australia, the New South Wales Ministry of Health is piloting an innovative Integrated Care Program in Western Sydney, foccussed on care facilitator roles to coordinate patient care between General Practices and hospitals. 

Jan. 23, 2018 Americas Publication

Towards Patient-Centered Conflicts of Interest Policy

Financial conflicts of interest exist between industry and physicians, and these relationships have the power to incluence physicians´medical practice. Transparency about conflicts matters for ensuring adequate informed consent, controlling healthcare expenditure, and encouraging physicians´reflection on professionalism. The US Centers for Medicare & Medicaid Services (CMS) launched the Open Payments Program (OPP) to publicly disclose and bring transparency to the relationships between industry and physicians in the United States. These changes considerably improve transparency and the utility of available data, and caan furthermore enhance professionalism and accountability by encouraging physicians to reflect more actively on their own practices. 

Sept. 21, 2017 Europe Publication

Imperial child health general practice hubs

For most children, the GP is their main point of contact with the health servivce. While children make up nearlyy one-fifth of the population in England, they are estimated to account for two-fifths of a typical GP´s workload. Despite this, the Royal College of Paediatrics and Child Health estimate that in many parts of the country, between 40 and 50 per cent of GPs have a had little or no formal paediatric training. Evidence suggest that many of these case could be managed outside an acute setting. 

June 16, 2016 Europe Event

Digital Health and Care Congress 2016. Enabling patient-centred care through information and technology

The congress will feature presentations and case studies from: NHS trusts; clinical commissioning groups; local authorities; voluntary sector organisations; universities and private sector providers, who will present innovative projects that are using technology and data to deliver high-quality sustainable health and care services.

May 17, 2016 Europe Publication

Person-centered care - ready for prime time

Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the ...

March 3, 2016 Americas Publication

The patient-as-partner approach in health care: a conceptual framework for a necessary transition.

A new model to enforce the partnership between patients and healthcare professionals has been developed at the University of Montreal’s Faculty of Medicine. Their patient-as-partner approach is rooted in patient-centered perspectives that have inspired previous initiatives like shared decision making, therapeutic education, expert patient and self-management. The main contribution of “Montreal model” is to consider the patient as a caregiver of himself and, as such, a genuine member of the treatment team, endowed with competencies and limitations just like any other member of the team.
This article describes the theoretical basis and summarize the main achievements of this innovative approach, established since 2010. Authors examine the issues of patient partnerships on medical practice and medical education cultures. Two key challenges are identified: 1) Integrate patients in existing professional education structures, instead of separate spaces as patient’s universities and 2) Develop a formal recruitment process for those patients, including ...

June 1, 2015 Western Pacific Publication

People-centred health care

In recent years, there has been increasing interest in the patient’s perspective of health care and how health systems can better respond to the needs of all health care stakeholders and constituencies in a holistic manner. Previous recommendations of Member States through the WHO Regional Committees for the Western Pacific and South-East Asia reflect the need to pursue work in the following: equity and fairness into policies; the development of programmes firmly grounded in ethical principles; the quality of health care and patient safety; human dignity, patients’ rights and needs, and the role of families, culture and society; the broader psychosocial and cultural determinants of health; and ethics related to medical practice, research and education. These issues have widespread relevance and significance. Improving health care quality and safety and enhancing the people’s experience of care require attention not only to health system design but also to the focus ...