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A framework for understanding outcomes of integrated care programs for the hospitalised elderly.

Hartgerink JM, Cramm JM, van Wijngaarden JD, Bakker TJ, Mackenbach JP, Nieboer AP - Int J Integr Care (2013)

Bottom Line: Insight is gained into how these components alter the way care is delivered through mechanisms such as combining individual knowledge and actively seeking new information.We expect that insight into the cognitive and behavioural mechanisms will contribute to the understanding of integrated care programmes.The framework can be used to identify the underlying mechanisms of integrated care responsible for producing favourable outcomes, allowing comparisons across programmes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Social Medical Sciences, Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

ABSTRACT

Introduction: Integrated care has emerged as a new strategy to enhance the quality of care for hospitalised elderly. Current models do not provide insight into the mechanisms underlying integrated care delivery. Therefore, we developed a framework to identify the underlying mechanisms of integrated care delivery. We should understand how they operate and interact, so that integrated care programmes can enhance the quality of care and eventually patient outcomes.

Theory and methods: Interprofessional collaboration among professionals is considered to be critical in integrated care delivery due to many interdependent work requirements. A review of integrated care components brings to light a distinction between the cognitive and behavioural components of interprofessional collaboration.

Results: Effective integrated care programmes combine the interacting components of care delivery. These components affect professionals' cognitions and behaviour, which in turn affect quality of care. Insight is gained into how these components alter the way care is delivered through mechanisms such as combining individual knowledge and actively seeking new information.

Conclusion: We expect that insight into the cognitive and behavioural mechanisms will contribute to the understanding of integrated care programmes. The framework can be used to identify the underlying mechanisms of integrated care responsible for producing favourable outcomes, allowing comparisons across programmes.

No MeSH data available.


Evaluation model for integrated care programmes for elderly in hospitals.
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fg001: Evaluation model for integrated care programmes for elderly in hospitals.

Mentions: Our framework is based on the principles of programme theory, which consists of a set of statements that describe a particular programme, explain why, how and under what conditions the programme effects occur, predicts the outcome of the programme and specifies what needs to be done to bring about the desired outcomes [46,47]. A review of literature on integrated care programmes [12,48–50] allowed us to define the presenting problem and to unravel the changes in care delivery that are expected and the way in which change is to be achieved. The theory of organisational knowledge creation helps to understand the process of making knowledge available and amplifying knowledge created by individuals as well as connecting it to others’ knowledge [51]. This theory allowed us to identify the cognitive and behavioural mechanisms underlying interprofessional collaboration and integrated care delivery. By identifying the underlying mechanisms of integrated care delivery we may increase our understanding of how they operate and interact in order to enhance quality of care and eventually patient outcomes. The main purpose of the evaluation model is to test the programme theory, and to identify what it is about the programme that causes the intended outcomes. The evaluation model incorporates variables that reflect theoretical concepts of integrated care evaluation for elderly in hospital settings. In the following sections, we conceptualise integrated care processes to identify the mechanisms responsible for producing intended outcomes. Such a theoretical structure selects outcomes that correspond to improved service delivery (aligning care with the needs of elderly patients, coordination and collaboration, resource utilisation [12]) and reflect the primary goal of integrated care, namely, enhancing patients’ quality of life (Figure 1).


A framework for understanding outcomes of integrated care programs for the hospitalised elderly.

Hartgerink JM, Cramm JM, van Wijngaarden JD, Bakker TJ, Mackenbach JP, Nieboer AP - Int J Integr Care (2013)

Evaluation model for integrated care programmes for elderly in hospitals.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3860580&req=5

fg001: Evaluation model for integrated care programmes for elderly in hospitals.
Mentions: Our framework is based on the principles of programme theory, which consists of a set of statements that describe a particular programme, explain why, how and under what conditions the programme effects occur, predicts the outcome of the programme and specifies what needs to be done to bring about the desired outcomes [46,47]. A review of literature on integrated care programmes [12,48–50] allowed us to define the presenting problem and to unravel the changes in care delivery that are expected and the way in which change is to be achieved. The theory of organisational knowledge creation helps to understand the process of making knowledge available and amplifying knowledge created by individuals as well as connecting it to others’ knowledge [51]. This theory allowed us to identify the cognitive and behavioural mechanisms underlying interprofessional collaboration and integrated care delivery. By identifying the underlying mechanisms of integrated care delivery we may increase our understanding of how they operate and interact in order to enhance quality of care and eventually patient outcomes. The main purpose of the evaluation model is to test the programme theory, and to identify what it is about the programme that causes the intended outcomes. The evaluation model incorporates variables that reflect theoretical concepts of integrated care evaluation for elderly in hospital settings. In the following sections, we conceptualise integrated care processes to identify the mechanisms responsible for producing intended outcomes. Such a theoretical structure selects outcomes that correspond to improved service delivery (aligning care with the needs of elderly patients, coordination and collaboration, resource utilisation [12]) and reflect the primary goal of integrated care, namely, enhancing patients’ quality of life (Figure 1).

Bottom Line: Insight is gained into how these components alter the way care is delivered through mechanisms such as combining individual knowledge and actively seeking new information.We expect that insight into the cognitive and behavioural mechanisms will contribute to the understanding of integrated care programmes.The framework can be used to identify the underlying mechanisms of integrated care responsible for producing favourable outcomes, allowing comparisons across programmes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Social Medical Sciences, Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

ABSTRACT

Introduction: Integrated care has emerged as a new strategy to enhance the quality of care for hospitalised elderly. Current models do not provide insight into the mechanisms underlying integrated care delivery. Therefore, we developed a framework to identify the underlying mechanisms of integrated care delivery. We should understand how they operate and interact, so that integrated care programmes can enhance the quality of care and eventually patient outcomes.

Theory and methods: Interprofessional collaboration among professionals is considered to be critical in integrated care delivery due to many interdependent work requirements. A review of integrated care components brings to light a distinction between the cognitive and behavioural components of interprofessional collaboration.

Results: Effective integrated care programmes combine the interacting components of care delivery. These components affect professionals' cognitions and behaviour, which in turn affect quality of care. Insight is gained into how these components alter the way care is delivered through mechanisms such as combining individual knowledge and actively seeking new information.

Conclusion: We expect that insight into the cognitive and behavioural mechanisms will contribute to the understanding of integrated care programmes. The framework can be used to identify the underlying mechanisms of integrated care responsible for producing favourable outcomes, allowing comparisons across programmes.

No MeSH data available.